CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 22 0000. ref SDS 16 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 090519 1613 Millie responded, ref SDS 8 8V8H, to the Doctor's
040902 - letter earlier yesterday afternoon on 090519 1536, ref SDS 7 5K7H;
040903 - and, Millie asks the doctor to prescribe treatment so she can recover
040904 - from cancer, as done previously in patient history, ref SDS 8 TY3X,
040905 - and further as planned by the doctor during the meeting on 090515
040906 - 1140. ref SDS 6 655R  Millie also asked the doctor to call on
040907 - expediting treatment in time to be effective, see again on 090520
040908 - 1613, ref SDS 8 TY4W; and Millie asks Doctor Rugo for a "drop dead"
040909 - date on how soon treatment must start in order to be effective, also,
040910 - reported on 090519 1613. ref SDS 8 TX4W
040912 -  ..
040913 - Since Kaiser has delayed ordering treatment, reported on 090520 1710.
040914 - ref SDS 13 ZF4Q, then on 090521 0211 Millie's letter to Doctor Rugo at
040915 - UCSF with copy to Doctor Hsu asks about getting treatment with
040916 - hyperthermia and Doxil, while Kaiser resolves delays ordering MPA
040917 - prescribed by Doctor Rugo for Millie to recover from 8th relapse of
040918 - cancer, which Millie reports is getting worse every day, ref SDS 14
040919 - FM7Q, and since Kaiser has previosuly authorized treatment with
040920 - hyperthermia and Doxil, which Doctor Rugo recommended earlier on
040921 - 090129 for Millie to recover from the 7th relapse. ref SDS 14 6M4F
040923 -  ..
040924 - On 090521 2006, Millie received a letter from Doctor Johnson
040925 - responding to Millie's letter to the medical team on 090520 1710, and
040926 - requesting that Kaiser prescribe treatment suitable for Millie's
040927 - patient profile for recovering from 8th relapse of cancer. ref SDS 13
040928 - P65H   Doctor Johnson's letter was sent through Kaiser's Knowledge
040929 - Management System and so was not disclosed to the medical team, and it
040930 - did transmit the Doctor Johnson's medical chart for the meeting on
040931 - 090515, ref SDS 6 YT5N, and said that Millie could "choose" any
040932 - treatment she wants, and no treatment is superior for Millie's patient
040933 - profile, 090521 2006, ref SDS 16 9Q9H; the doctor noted Millie's
040934 - cancer is progressing and so she needs to start treatment by the end
040935 - of the week, which was in just 12 hours, which means today,
040936 - ref SDS 16 HC8O, and the doctor told Millie to call Medicare for
040937 - prescribing treatment to recover from the 8th relapse of cancer.
040938 - ref SDS 16 HC93
040940 -  ..
040941 - On 090522 0813 Millie responded to Doctor Johnson's letter on 090521
040942 - 2006 and submitted copies to the medical team to maintain
040943 - collaboration that has been effective treating Millie the past 8
040944 - years.  Millie also sent a copy to Jullian Kwok to notify Medicare
040945 - that Kaiser is refusing treatment. ref SDS 17 RX6L  Millie asked
040946 - Kaiser to prepare a workup and Tumor Board to evaluate Millie's next
040947 - treatment, including trade-offs comparing all of the treatments
040948 - available for Millie. ref SDS 17 7Z5Y  Millie reports having called
040949 - Kaiser numerous times to speak with the doctor on prescribing
040950 - treatment. ref SDS 17 7Z9Y  Millie notifies medical team she chooses
040951 - hyperthermia and radiation, Doxil, or other agent suitable for
040952 - Millie's patient profile. ref SDS 17 715V
040954 -  ..
040955 - On 090522 1247 Millie received a response from Doctor Johnson to
040956 - Millie's letter on 090522 0813. ref SDS 17 RX6L who sent copies to the
040957 - medical team, and saying Kaiser has performed workups, but does not
040958 - submit any works, and says Millie's patient profile is too complex for
040959 - Tumor Board to evaluate best course of treatment, and that Millie's
040960 - patient profile resists single agent treatments like Gemzar and
040961 - Navelbine, and that Millie can choose Hospice instead of treatment
040962 - with drugs which her patient profile now resists. ref SDS 18 XO5O
040964 -  ..
040965 - On 090522 1351 Millie responded to Kaiser's letter submitted by Doctor
040966 - Johnson on 090522 1247, ref SDS 18 XO5O, confirming Millie needs
040967 - urgent treatment to start quickly, reported on 090522 1351,
040968 - ref SDS 19 7R7J; Millie asks if treatment with Gemzar and Navelbine
040969 - will be weeks of agony then progression of cancer that requires
040970 - another treatment "targeted" to treat Millie's patient profile.
040971 - ref SDS 19 2T4S  Millie requested advice on treatment with a clinical
040972 - trial at Kaiser, based on patient history, ref SDS 19 2T4V, and
040973 - further requested trade-offs getting more hyperthermia and radiation
040974 - and Doxil or other appropriate agent, including vaccines. ref SDS 19
040975 - 2T4Y
040977 -  ..
040978 - Millie Over-treated Cannot Estimate Time to Progression
040979 - May Not Work at All Millie Over-treated Patient Profile Resists Chemo
040980 - Unfortunately Chemotherapy Drugs Proposed by Kaiser May Not Work at All
040981 - Targeted Treatment Essential Millie's Patient Profile to Recover 8th Relapse
040982 -
040983 - Follow up ref SDS 21 NV4L. ref SDS 20 NV4L.
040984 -
040985 - On 090522 1953 Millie received a letter from Doctor Johnson responding
040986 - to Millie's letter to the medical team at Kaiser and UCSF this
040987 - afternoon, reported on 090522 1351. ref SDS 19 7R7J  For some reason,
040988 - the doctor he did not submit copies to the medical team, demonstrating
040989 - uneven case management for coordination and collaboration; the doctor
040990 - confirms that treatment with single-agent chemotherapies presented as
040991 - the only choices for care may not work at all for Millie to recover
040992 - from 8th relapse of cancer. ref SDS 20 NV4L
040994 -  ..
040995 - On 090523 0148 Millie sent a letter to Paula in the Kaiser Claims
040996 - Department with copy to medical team for requesting treatment to
040997 - recover from 8th relapse applying standard of care for Millie's
040998 - patient profile. ref SDS 21 2P6J
040999 -
041000 -
041002 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Paula nor anyone else has responded to Millie's demand for care in her
041402 - letter to Kaiser on 090523 0148. ref SDS 21 2P6J
041404 -  ..
041405 - Millie's cancer is getting worse.  This morning called for Paula in
041406 - the Pleasanton Kaiser Office of Member Services.
041408 -  ..
041409 - Paula was not in the office.  Left a voice message.
041410 -
041411 -
041413 -  ..
0415 -
0416 -
0417 - 0953
0418 -
041801 - Called Paula back.
041802 -
041803 - Paula said she sent Millie's letter to Kaiser dated 090523 0148,
041804 - ref SDS 21 2P6J, to Kaiser's Expedited Claims Department.  She feels
041805 - that Expedited claims department must process Millie's request first,
041806 - then when a denial is issued, Millie can request further review in her
041807 - office at the Member Services Claims Resolution Department.
041809 -  ..
041810 - Advised that someone from Kaiser called Millie this morning, and
041811 - would not explain what is needed.
041813 -  ..
041814 - Reviewed the record that Paula originally referred Millie's case to
041815 - Expeditied claims, reported on 090520 1153. ref SDS 11 T65H  The next
041816 - day, Pamela in Expedited Claims referred the case back to Paula's
041817 - Department in Member Services Claims Resolution, 090521 0902,
041818 - ref SDS 15 UD5H, and now today Paula feels the case should be referred
041819 - back to Expedited Claims.
041821 -         ..
041822 -        [On 090528 1228 Millie notifies Paula in Member Services Claims
041823 -        Resolution objects to delaying treatment caused by errors
041824 -        referring treatment back and forth between Departments.
041825 -        ref SDS 23 4M6Y
041827 -  ..
041828 - This is a "loop" that denies Millie urgent medical treatment which her
041829 - doctor said should been provided no later than 090522, reported on
041830 - 090521 2006. ref SDS 16 HC8O  Doctor Johnson warned on 090213 that
041831 - Millie's 8th relapse of cancer is very aggressive. ref SDS 5 UP6L
041832 - Kaiser is allowing stage IV cancer to progress for 2 months without
041833 - treatment, while bouncing the patient back and forth delaying care
041834 - with time running out (as the Titanic sinks) on ability of any care to
041835 - be effective.
041836 -
041837 -        [On 090601 0818 at 1412 woman from Expedited Claims called and
041838 -        said Kaiser does not understand Millie's claim for standard of
041839 -        care to treat Millie's 8th relapse of cancer in time to be
041840 -        effective. ref SDS 24 TG5G
041841 -
041843 -  ..
041844 - Authorization for Representation Mailed by to Millie by Kaiser
041845 -
041846 - Paula said not to worry.  Kaiser's records show that authorization for
041847 - representation which Millie submitted to Kaiser in October of 2007 has
041848 - expired.  She will send an internal email to request the authorization
041849 - department send Millie another form in the mail, which Millie can fill
041850 - out and mail back to Kaiser updating Kaiser's records authorizing
041851 - patient assistance, which Millie has had for 8 years.  Paula will ask
041852 - the authorization department to include a return envelope with the
041853 - form to expedite Millie's authorization for patient assistance.  She
041854 - feels this should only take 5 - 10 days, assuming the form is mailed
041855 - to Millie before the weekend.  Paula emphasized that Millie send the
041856 - form back to Kaiser as soon as possible.
041858 -         ..
041859 -        [On 090528 1228 Millie asked for location to go sign Kaiser's
041860 -        forms to mitigate damage from further delay; Kaiser failed to
041861 -        respond. ref SDS 23 4N7U
041863 -         ..
041864 -        [On 090601 0818 Millie received authorization form from Kaiser
041865 -        in the mail; she signed and faxed the form to Kaiser, and
041866 -        received notification of successful delivery. ref SDS 24 UD5H
041868 -         ..
041869 -        [On 090601 0818 at 1412 woman from Expedited Claims called and
041870 -        Kaiser did not receive Millie's form authorizing
041871 -        representation. ref SDS 24 PR4S
041873 -  ..
041874 - Paula asked not to get any more emails expditing Millie's care,
041875 - because she is very busy with other patients.
041877 -  ..
041878 - Discussed opportunity to save time and money by assisting the Doctor
041879 - order prescribed care.  The Member Services Claims Resolution office
041880 - has authority and responsibility to resolve mistakes in time for
041881 - Kaiesr to deliver effective care, shown by Paula's call on 071006,
041882 - ref SDS 2 0001, and by Paula's subsequent letter received from Kaiser
041883 - on 071204. ref SDS 3 TH8L  Failure to perform increases delay for
041884 - doctors and patients, and greatly increases costs of care required by
041885 - EOC section 2, reviewed on 070927 1311. ref SDS 1 WS6M
041887 -  ..
041888 - Paula summarized Millie's claim as a request for treatment in a
041889 - clinical trial.
041891 -  ..
041892 - Explained Millie does not request treatment in a clinical trial; she
041893 - requests in her letter on 090523 a prescription for treatment based on
041894 - the best evidence for standard of care, ref SDS 21 DQ5S, to treat her
041895 - patient profile. listed in the meeting with the doctor on 090213 1140.
041896 - ref SDS 5 ES7I  The doctor has prescribed clincial trials many times,
041897 - because best evidence showed treatments provided standard of care in
041898 - Millie's case, cited in Millie's letter on 090523 0148, ref SDS 21
041899 - DQ8P
041901 -         ..
041902 -        [On 090528 1228 letter to Paula in Kaiser Member Services
041903 -        Claims Resolution Department with copy to medical team confirms
041904 -        telecon with Paula this morning that Millie demands treatment
041905 -        for 8th relapse of cancer. ref SDS 23 4N3R
041907 -  ..
041908 - Millie's claim for urgent treatment was presented to the Expedited
041909 - Claims Department on 090520 1203. ref SDS 12 9595, and was cited in
041910 - the letter to Paula on 090523 requesting Kaiser perform requirements
041911 - of EOC section 2 in the insurance agreement that entitles Millie to
041912 - analysis from the doctor explaining trade-offs for treatments, and a
041913 - prescription for standard of care in time to be effective.  During the
041914 - call today, Paula reviewed Millie's letter and noted her claim for
041915 - medical services to recover from her 8th relapse of cancer.
041916 - ref SDS 21 DQ5S
041918 -  ..
041919 - Explained Millie requests that Kaiser provide standard of care for her
041920 - patient profile listed in the meeting with the doctor on 090213 1140,
041921 - ref SDS 5 ES7I, and specified under EOC section 2, reviewed on 070927.
041922 - ref SDS 1 WS6M
041924 -  ..
041925 - Paula noted that Kaiser policy is to prescribe treatment based on best
041926 - evidence of effectiveness, and patient quality of life, which she
041927 - cited previously on 090520 1153. ref SDS 11 HX3O
041929 -  ..
041930 - Paula said that she is meeting in a few minutes with a colleague who
041931 - has responsibility for Millie's case.  Paula will explain that Millie
041932 - needs urgent support from the Claims Resolution Department to assist
041933 - her doctor prescribe treatment quickly in time to be effective.
041934 -
041935 -
041936 -
041937 -
041938 -
041939 -
041940 -
041941 -
041942 -
041943 -
041944 -
0420 -