THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net
S U M M A R Y
DIARY: November 12, 2009 12:29 PM Thursday;
Rod Welch
Called Paula to discuss Millie's claims for insurance coverage.
1...Summary/Objective
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CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up
040502 -
040503 -
040504 -
040506 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Followed up call on 090731, when Paula was investigating how Kaiser
040902 - can secure Millie's rights. ref SDS 6 BD5I
040904 - ..
040905 - Background on Paula's support for Millie's claim is reported in case
040906 - study listed on 090727 1153. ref SDS 5 BD5I
040908 - ..
040909 - This afternoon, discussed meeting this morning with Doctor Johnson,
040910 - who is treating Millie without regard to Kaiser's and Millie's claim
040911 - against UCSF, reported on 091112 0930, ref SDS 8 H54F
040913 - ..
040920 - ..
040921 - Explained Millie's entitlement presented in her letter to the medical
040922 - team this morning at 0732, which transmitted the agenda for meeting at
040923 - 0930, with Doctor Johnson at Kaiser, reported on 091112 0752,
040924 - ref SDS 7 L64X
040926 - ..
040927 - Paula indicated that Kaiser's policy is to pay for 2nd opinions that
040928 - are implemented by Kaiser for patient care.
040930 - ..
040931 - Paula read over the telephone a record prepared by Kaiser's Expedited
040932 - Claims Department, which purported to report on a telephone
040933 - conversation presenting Millie's claim for medical services. There
040934 - were two calls with Expedited claims, initiated at Paula's request on
040935 - 090525...
040936 -
040937 - 1. On 090520 1203 called Kaiser Expedited Claims in Oakland,
040938 - ref SDS 3 4M9G, and talked to Pamela Powell, ref SDS 3 PQ8P,
040939 - and presented Millie's claim to get treatment for standard of
040940 - care in time to be effective recovering from her 8th relapse of
040941 - cancer. ref SDS 3 9595
040943 - ..
040944 - 2. On 090521 0902 Pamela called back and said Expedited Claims
040945 - cannot rule on Millie's request for support, because Millie's
040946 - case falls through the cracks; Expedited claims cannot deny
040947 - Millie's request for the doctor to prescribe treatment, but do
040948 - not want to issue an order for a Kaiser doctor to prescribe
040949 - care for a patient, and so Expedited Claims called Doctor
040950 - Johnson to encourage resolution, and also submitted the case to
040951 - Member Services in Pleasenton. ref SDS 4 UD5H
040953 - ..
040954 - The narrative Paula read from Kaiser's report on conversations with
040955 - Expedited Claims seemed considerably different from understandings for
040956 - the call reported on 090520 1203, ref SDS 3 PQ8P, and for the follow
040957 - up call the next day on 090521 0902. ref SDS 4 X68I
040959 - ..
040960 - Nothing that was actually stated in call with the Expedited Claims
040961 - Department was included in the record prepared by Expedited Claims, as
040962 - read by Paula from Kaiser's computer this afternoon, and nothing in
040963 - the report prepared by the Expedited Claims Department was actually
040964 - stated in the telephone call with Expedited claims.
040966 - ..
040967 - Paula seemed to say, in the call today, that she has been told by
040968 - management that Kaiser does not want to demand performance from UCSF
040969 - on correcting medical mistakes, nor recover costs from UCSF for
040970 - defective work on Kaiser's referral for Millie to get radiation
040971 - medical services beginning on 090219 and to 090317. She explained
040972 - that Kaiser has a good business relationship with UCSF, and Kaiser's
040973 - management feels this would be damaged by Kaiser demanding that UCSF
040974 - remedy injuries Millie suffered getting radiation medical services on
040975 - referral from Kaiser. Paula feels Kaiser will never hold UCSF
040976 - responsible for medical mistakes in Millie's case.
040977 -
040978 - [On 100606 2314 Kaiser steadfastly refuses communication
040979 - with Kaiser to save the life of a patient shows Kaiser is
040980 - not benefitting from a "good business relationship with
040981 - UCSF. ref SDS 10 036C
040983 - ..
040984 - [On 100607 1021 Paula seems to revise understandings
040985 - presented today, saying Kaiser does not object to demanding
040986 - UCSF correct medical mistakes. ref SDS 11 QN4M
040988 - ..
040989 - [On 100607 1117 letter to Paula confirms new understanding
040990 - today, that Kaiser does not object to demanding UCSF
040991 - correct medical mistakes that occurred providing Millie's
040992 - care on referral from Kaiser. ref SDS 12 R34P
040994 - ..
040995 - [On 100607 1117 letter to Paula notes that Kaiser can
040996 - resolve Millie's claim by notifying UCSF to commence work
040997 - within 10 days to repair Millie's injuires caused by UCSF
040998 - medical mistakes, and if Kaiser fails to perform, then
040999 - Kaiser will hire someone else and bill UCSF. ref SDS 12
041000 - R34P
041002 - ..
041003 - Therefore Kaiser has elected to provide treatment limited by Millie's
041004 - health insurance paid by Medicare, rather than provide necessary and
041005 - reasonable care to recover from medical mistakes, and obtain payment
041006 - from UCSF.
041008 - ..
041009 - [On 100528 0322 Millie requested Medicare support for
041010 - quality care, and conformance with entitlement to recover
041011 - from medical mistakes getting radiation treation on
041012 - referral from Kaiser, ref SDS 9 QQ6N; asked Medicare to
041013 - hold Kaiser accountable for Millie's care because desire to
041014 - have good business relationship with UCSF does not excuse
041015 - failure to provide effective care. ref SDS 9 QZ5U
041017 - ..
041018 - Paula proposed that Millie ask UCSF for recovery of damages from
041019 - defective medical services, rather than claim recovery from Kaiser,
041020 - and demand that Kaiser recover damages from UCSF. She feels there is
041021 - nobody at Kaiser who will exercise Kaiser's responsibility to Millie
041022 - for recovering from UCSF's defective work providing radiation medical
041023 - services ordered and paid on referral by Kaiser.
041025 - ..
041026 - Paula is not sure what to do in this case.
041028 - ..
041029 - She asked how Millie is doing?
041031 - ..
041032 - Explained not well. Chemotherapy is not working, which everydoby knew
041033 - before UCSF proposed it in July. She is very tired and weak from side
041034 - effects, staying in bed most of the time from pills to suppress pain,
041035 - reported in Millie's letter to the team this morning, reported on
041036 - 091112 0752, ref SDS 7 L65W, and discussed with Doctor Johnson at
041037 - Kaiser in a meeting this morning finding Millie's cancer is getting
041038 - worse, and so her treatment must be changed again. ref SDS 8 H54F
041040 - ..
041041 - Paula plans to inquire further.
041042 -
041043 -
041044 -
041045 -
041046 -
041047 -
041048 -
041049 -
041050 -
041051 -
0411 -