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: June 18, 2010 08:43 AM Friday;
Rod Welch
Called Kaiser Case Resolution for Jennifer on Millie's claim.
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 ref SDS 57 0000. ref SDS 56 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 - ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 010427 0830 meeting at Kaiser - Doctor Johnson notes Millie looks
040902 - so good nobody can believe she has such severe cancer, ref SDS 19
040903 - OJ6I; the doctor explained again Millie's cancer has mutated through
040904 - 11 relapses to resist chemotherapy. The doctor advised that Kaiser
040905 - has a new strategy prescribing therapy that is effective for treating
040906 - cancer as a chronic disease by "targeting" the genetic profile of
040907 - cancer that has mutated in patients, like Millie, to resist
040908 - chemotherapy. ref SDS 19 SJ6N
040910 - ..
040911 - On 100501 1037 Millie letter to medical team confirms understanding of
040912 - new strategy to treat Millie's cancer with targeted therapy.
040913 - ref SDS 20 F25O
040915 - ..
040916 - On 100501 2017 Doctor Rugo reports plans to collaborate with Doctor
040917 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040918 - of cancer caused by UCSF medical mistakes. ref SDS 21 HH4I
040920 - ..
040921 - On 100502 2143 Kaiser confirms that some patients respond well to new
040922 - "targeted" therapies. ref SDS 22 YX8L Kaiser contends that all of the
040923 - strategies for "targeted" therapies have been executed for Millie,
040924 - which seems conflicting with the record in this case. ref SDS 22 MZ4N
040926 - ..
040927 - On 100503 1522 Millie notifies medical team that time of the essence
040928 - to get the next treatment going. ref SDS 23 TD5W
040930 - ..
040931 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040932 - with Abraxane chemotherapy that seems to be failing, and then after 3
040933 - more weeks without treatment, following a trip abroad, the doctor will
040934 - discuss "next steps." ref SDS 24 YL5N
040936 - ..
040937 - On 100503 2338 Millie reports to medical team that she will implement
040938 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040939 - letter on 010503, as assurance that recovery will be equal to changing
040940 - treatment immediately on 100505. ref SDS 25 6X7S
040942 - ..
040943 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040944 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040945 - communicate with Doctor Johnson, or had already done so, to coordinate
040946 - with Kaiser on planning Millie's next treatment to recover from the
040947 - 11th relapse of cancer. ref SDS 26 NT5N
040949 - ..
040950 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040951 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040952 - ref SDS 27 KE4K
040954 - ..
040955 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040956 - seemingly on an accelerating rise, which threatens to cascade out of
040957 - control, because Abraxane chemotherapy is not effective. ref SDS 28
040958 - L54I
040960 - ..
040961 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040962 - Abraxane. ref SDS 29 KE4K
040964 - ..
040965 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 30 PK9O
040967 - ..
040968 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040969 - Department for standard of care to recover from 11th relapse of cancer
040970 - caused by medical mistakes getting radiation treatments at UCSF on
040971 - referral from Kaiser. ref SDS 31 IZ7N
040973 - ..
040974 - On 100528 0322 Millie requests support from Medicare to separate
040975 - recovery for medical mistakes getting radiation from UCSF, from health
040976 - care benefits limited by Medicare insurance coverage. ref SDS 32 QQ6N
040978 - ..
040979 - On 100528 1031 called Medicare they have formed a team to review
040980 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040981 - response to Millie's claim. ref SDS 33 4W5F
040983 - ..
040984 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040985 - collaborate with UCSF on treatment for Millie to recover from UCSF
040986 - medical mistakes. He discussed treating Millie with MPA, but this was
040987 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040988 - ended the treatment due to fears about blood clot side effects, which
040989 - were believed to cause breathing problems Millie had, though later
040990 - breathing problems were discovered to be caused by defective radiation
040991 - treatment. Since Doctor Johnson said Kaiser has no more treatments
040992 - for Millie, the only way Millie can get relief from pain caused by
040993 - cancer that is progressing without treatment is get treatment in
040994 - Hospice. Since Hospice is the only choice of care offered today,
040995 - Millie accepted this.
040997 - ..
040998 - On 100601 1531 Sharon called to schedule starting Hospice medical
040999 - services beginning tomorrow between 0900 - 1000. ref SDS 20 036C
041001 - ..
041002 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041003 - Sharon's report yesterday, that if Kaiser performs on the insurance
041004 - agreement to provide standard of care for Millie's patient profile,
041005 - than Millie can elect to recover from 11th relapse of cancer, rather
041006 - than continue with Hospice support for dying peacefully. ref SDS 21
041007 - 036C
041009 - ..
041010 - On 100602 1046 Diane received notice from Medicare to file claim for
041011 - Millie to get treatment for recovering from UCSF medical mistakes; she
041012 - is preparing a statement of claim. ref SDS 38 036C Advised Diane to
041013 - use Millie's statement of claim submitted to Kaiser on 100527.
041014 - ref SDS 38 MZ5H Eileen called later and reported that Kaiser denied
041015 - Millie's claim on the grounds that Medicare does not authorize payment
041016 - for treatment to recover from cancer, after a patient starts Hospice.
041017 - ref SDS 38 UN4M Requested that Eileen read he claim and then make a
041018 - good faith determiantion. ref SDS 38 I33H Eileen called back after
041019 - reading the claim and advised the denial of claim has been withdrawn,
041020 - and the matter is referred to Claims Resolution Department.
041021 - ref SDS 38 UN5P
041023 - ..
041024 - On 100603 0449 Millie notified medical team that Kaiser called today
041025 - about moving forward to resolve medical mistakes getting radiation
041026 - treatment at UCSF on referral from Kaiser. ref SDS 39 IX9Q
041028 - ..
041029 - On 100606 1604 Doctor Johnson notifies Millie that her cancer marker
041030 - has remained fairly stable the past 3 weeks since ending treatment
041031 - with Abraxane on 100512; actually went up less without Abraxane, than
041032 - with it, because Millie's cancer resists chemotherapy. ref SDS 40 036C
041034 - ..
041035 - On 100606 1638 Millie thanks Doctor Johnson for submitting good news
041036 - cancer marker CA 15-3 606 much smaller rise than exptected after
041037 - ending treatment for 3 weeks. ref SDS 41 036C; asks if Doctor Rugo ever
041038 - returned Doctor Johnson's call from Kaiser, as planned in Doctor
041039 - Rugo's letter on 100501?
041041 - ..
041042 - On 100606 2317 Millie receives letter from Doctor Johnson reporting
041043 - that Doctor Rugo has never returned his call asking UCSF for Millie's
041044 - treatment plan, which demonstrates failure to perform on Doctor Rugo's
041045 - commitment in UCSF letter sent to the medical team on 100501.
041046 - ref SDS 42 036C
041048 - ..
041049 - On 100607 0932 called Cherry at Medicare about progress on contacting
041050 - Kaiser to process Millie's claim filed on 100527, and planned in the
041051 - call with Medicare (Cherry and Beth) as action item #8, planned the
041052 - next day on 100528 1031, ref SDS 33 PE6P; today, Cherry did not have
041053 - time to return the call. ref SDS 43 036C
041055 - ..
041056 - On 100607 1021 called Paula at Kaiser - she said someone else is
041057 - handling Millie's claim, because the claim has not been denied, and
041058 - Paula only handles denied claims. ref SDS 44 036C; Paula further
041059 - reported that Kaiser no longer objects to demaning UCSF correct
041060 - medical mistakes, so Millie's claim should be easy to resolve.
041061 - ref SDS 44 QN9F
041063 - ..
041064 - On 100607 1117 letter to Paula confirming Kaiser's work plan to
041065 - process Millie's claim for care promptly in order to save her life.
041066 - ref SDS 45 036C
041068 - ..
041069 - On 100608 1521 called and talked to Cherry and Beth about expediting
041070 - Millie's claim at Kaiser. ref SDS 46 036C Developed work plan to have
041071 - a conference call with Kaiser tomorrow. ref SDS 46 C354 Submitted
041072 - letter to Kasier and CMS Medicare confirming work plan for tomorrow.
041073 - ref SDS 46 G84Q
041075 - ..
041076 - On 100609 1114 called CMS to expedite conference call on expediting
041077 - Millie's care. ref SDS 47 036C Cherry called and schedule telecon with
041078 - Kaiesr and CMS today 1300. ref SDS 47 8O4H Received letter from Cherry
041079 - at CMS confirming work plan for conference call at 1300. ref SDS 47
041080 - PRXY
041082 - ..
041083 - On 100609 1232 letter to CMS and Kaiser submitts agenda for conference
041084 - call to review progress on Kaiser resolving Millie's claim for
041085 - recovery from UCSF medical mistakes. ref SDS 48 036C
041087 - ..
041088 - On 100609 1300 CMS and Kaiser conference call to report progress on
041089 - reviewing Millie's claim for treatment to recover from UCSF medical
041090 - mistakes in time to be effective. ref SDS 49 036C
041092 - ..
041093 - On 100609 1522 Jennifer called for assistance processing Millie's
041094 - claim to recover from medical mistakes getting radiation treatment at
041095 - UCSF on referral from Kaiser. ref SDS 50 036C
041097 - ..
041098 - On 100611 1451 Jennifer advised Kaiser extended the date for
041099 - responding to Millie's claim from 100610 to 100624, based on Millie
041100 - filing updated statement of authorized representative. ref SDS 54 036C
041101 - Jennifer reported she reviewed 6-issues discussed on 100609, and will
041102 - address these issues responding to Millie's claim. ref SDS 54 FQ4G
041103 - Jennifer asked how Kaiser can treat Millie to recover from UCSF
041104 - medical mistakes, if Millie refuses chemotherapy and has entered
041105 - Hospice. ref SDS 54 FQ4M
041107 - ..
041108 - On 100611 2326 Millie received Jennifer's letter confirming the date
041109 - for Kaiser to respond to Millie's claim has been extended to 100624,
041110 - ref SDS 55 CV4O, and further advising that issues Kaiser will determine
041111 - responding to Millie's claim for recovering from UCSF medical
041112 - mistakes, ref SDS 55 036C, are as set out in the record for telecon on
041113 - 100609. ref SDS 50 XK50 Jennifer will call on 100615, to report
041114 - progress on respnding to Millie's claim. ref SDS 55 6P53
041116 - ..
041117 - On 100614 0257 letter to Kaiser Medicar CMS claim team requests
041118 - immediate written proposal evaluating treatment options for Millie to
041119 - consider. ref SDS 56 036C
041121 - ..
041122 - On 100616 0832 called Jennifer about her plan to call yesterday on
041123 - Tuesday to report progress Kaiser responding to Millie's claim, as set
041124 - out in Jennifer's letter on 100611. ref SDS 57 036C Jennifer called
041125 - back to ask if Millie wants UCSF or Kaiser to pay for her damages
041126 - caused by UCSF medical mistakes. ref SDS 57 PSSV Jennifer reported
041127 - delays communicating with Millie's medical team have delayed making
041128 - arrangements for Millie to start treatment recovering from UCSF
041129 - medical mistakes. ref SDS 57 OY4T She plans to call on Friday, 100618,
041130 - to report progress responding to Millie's claim. ref SDS 57 1K5J
041132 - ..
041133 - On 100618 0843 called Jennifer at Memeber Case Resolution Department
041134 - about progress responding to Millie's claim. ref SDS 0 036C
041135 -
041136 -
041137 -
041139 - ..
0412 -
0413 -
0414 - Progress
0415 -
041501 - Left message for Jennifer to call on progress solving Millie's claim,
041502 - planned in the call on 100616 0832. ref SDS 57 ZR8X
041504 - ..
041505 - Evidently, claim team is having continuing delays communicating with
041506 - the medical team, reported by Jennifer on 100616 0832. ref SDS 57 OY4T
041507 -
041508 - [On 100620 1112 letter to Kaiser, Medicare, and UCSF notifies
041509 - of delays communicating with medical team delays timely
041510 - treatment for Millie. ref SDS 58 L58U
041511 -
041512 -
041514 - ..
0416 -
0417 -
0418 - 0834
0419 -
041901 - Jennifer did not call back.
041902 -
041903 -
041904 -
041905 -
041906 -
0420 -