CONTACTS
SUBJECTS
Treatment Clinical Study Cetuximab Carboplatin Drug Trial Millie Rea
5303 -
5303 - ..
5304 - Summary/Objective
5305 -
530501 - Follow up ref SDS 27 0000. ref SDS 26 0000.
530502 -
530503 - Millie got blood drawn for tests to start treatment today, or
530504 - tomorrow. ref SDS 0 AS6M She wrote to Kaiser thanking Michelle for
530505 - coordinating resolution of treatment delays, ref SDS 0 C48M, and asked
530506 - UCSF about the time for treatment today or tomorrow. ref SDS 0 YF6Y
530507 - Jackie called in response to Millie letter and said that referral
530508 - authoriation has not been received from Kaiser, so there can be no
530509 - treatment today. ref SDS 0 4Q54 She was to call back later with the
530510 - time for Millie to get treatment tomorrow. ref SDS 0 4R31 Millie got
530511 - a letter from Michelle reporting Kaiser progress on submitting
530512 - authorization for Millie to get treatment at UCSF. ref SDS 0 PR3V
530513 - Millie thanked Michelle again for coordinating efforts at Kaiser to
530514 - solve the problem. ref SDS 0 EG7K Millie received a recent blood test
530515 - showing her cancer marker has increased significantly while waiting to
530516 - get treatment over the past 2 months. ref SDS 0 GK5B In the late
530517 - afternoon, Margaret called and said that UCSF has not been able to
530518 - obtain from Kaiser authorization documents for Millie's treatment.
530519 - This was a long explanation of significant efforts UCSF has made to
530520 - arrange for Millie's treatment. ref SDS 0 MW4H Margaret suggested
530521 - Millie ask her doctor at Kaiser for support to solve the problem.
530522 - ref SDS 0 LC7I Millie wrote a letter to her doctor asking for
530523 - assistance to end authorization delays so that cancer does not cascade
530524 - out of control. ref SDS 0 J94L Kaiser reported that Millie's doctor
530525 - is on vacation, and so there seems to be nobody who can take
530526 - responsibility. ref SDS 0 LP4L Jackie called and said that treatment
530527 - for tomorrow is now cancelled, and UCSF cannot schedule treatment
530528 - until referral authorization is received from Kaiser. ref SDS 0 J43I
530529 - Jackie further advised that delays to starting treatment will now
530530 - require Millie to get another CT test to meet clinical study
530531 - requirements, which will further delay treatment. ref SDS 0 J438
530532 - Jackie asked Millie to ask Kaiser again to submit authorization for
530533 - treatment at UCSF. ref SDS 0 FS33 Millie decided to take a short
530534 - vacation while Kaiser and UCSF resolve referall authorization issues.
530535 - ref SDS 0 PUPV
530536 -
530537 - [On 070124 Millie writes another letter requesting
530538 - Arlette to assist in resolving authorization issues,
530539 - ref SDS 30 YF8U, and then leaves town for short
530540 - vacation. ref SDS 30 KX9H
530542 - ..
530543 - [On 070125 UCSF schedules Millie for treatment on
530544 - 070131. ref SDS 31 YF8U
530545 -
530546 -
530547 -
530548 -
530549 -
530551 - ..
5306 -
5307 -
5308 - Discussion
5309 -
530901 - Treatment Delayed Not Enough Time Fix Kaiser Policy Conflict Medicare
530902 - Policy Conflict Kaiser Medicare Treatment Delayed Not Enough Time Fix
530903 - Medicare Policy Conflict Kaiser Treatment Delayed Not Enough Time Fix
530904 -
530905 - Follow up ref SDS 27 YF8U, ref SDS 26 YF8U.
530906 -
530907 - Millie submitted ref DIT 1 0001 to Michelle with copies to Arlette,
530908 - and to Jackie at UCSF confirming understandings from Michelle's call
530909 - yesterday, ref SDS 27 YF8U, and correspondence from the doctor,
530910 - ref DRP 6 0001, also received yesterday, ref SDS 27 LX8B, that Kaiser
530911 - has resolved problems which delayed treatment last week on Friday,
530912 - 070119. ref SDS 26 LW9N
530914 - ..
530915 - Millie's letter to Michelle at Kaiser says...
530916 -
530917 - 1. Thanks very much for your call yesterday explaining progress
530918 - resolving conflicts so I can get treatment at UCSF with the
530919 - drug trial that [my doctor] has prescribed. ref SDS 27 YF8U I
530920 - got a letter from the doctor last night saying he solved the
530921 - problem, ref SDS 27 LX8B, following up collaboration with
530922 - Doctor Rugo last Friday on 070119, ref SDS 26 4R4M, as related
530923 - by Jackie in our meeting at UCSF. ref SDS 26 AS96, ref DIT 1
530924 - 0001
530926 - ..
530927 - 2. By copy I am asking Jackie if I am supposed to come in this
530928 - morning to meet with Doctor Rugo, and then get my first
530929 - treatment. In our meeting at UCSF last Friday [on 070119],
530930 - Jackie indicated that Doctor Rugo wants treatment to start
530931 - today or at the latet tomorrow in order to comply with study
530932 - protocol. ref SDS 26 AS5H, ref DIT 1 UP6J
530934 - ..
530935 - Millie's letter to Arlette continues below explaining she got the
530936 - blood work done this morning requested by UCSF for getting treatment
530937 - today. ref SDS 0 AS6M
530938 -
530939 -
530941 - ..
5310 -
5311 -
5312 - 0842
5313 -
531301 - UCSF Reports Kaiser Conflict with Medicare Subsidiary Not Resolved
531302 -
531303 - Jackie at UCSF called.
531305 - ..
531306 - Jackie advised that insurance payment issues initially discussed
531307 - between the primary care physician and Doctor Rugo on 071230,
531308 - ref SDS 14 3X6K, have not been resolved between Kaiser and UCSF. This
531309 - clarifies understandings from Kaiser yesterday, ref SDS 27 PN4I, and
531310 - submitted to UCSF this morning; Jackie says Millie cannot start
531311 - treatment today, as discussed in Millie's letter, ref DIT 1 0001, to
531312 - Kaiser per shown above. ref SDS 0 YF8U
531314 - ..
531315 - Jackie understands that Kaiser and UCSF are working hard to resolve
531316 - policy conflict. Doctor Rugo expects this to occur today. Jackie
531317 - further indicated that Doctor Rugo expects to meet with Millie
531318 - tomorrow, and then Millie can start treatments also tomorrow after the
531319 - meeting, as originally planned for 070119. ref SDS 26 AS96
531321 - ..
531322 - Jackie will notify Millie later today confirming meeting and treatment
531323 - for tomorrow.
531324 -
531325 - [...below, Michelle reports that Pam at Kaiser is coordinating
531326 - with Lisa at UCSF to resolve policy conflicts and avoid
531327 - delaying Millie's treatment. ref SDS 0 575F
531329 - ..
531330 - [...below, Margaret reports UCSF has not received
531331 - authorization, and has been unable to make progress obtaining
531332 - required documentation from Kaiser. ref SDS 0 3S3J
531334 - ..
531335 - [...below, Jackie advises treatment scheduled for tomorrow on
531336 - 060124 delayed until further notice after Kaiser submits
531337 - authorization number for UCSF to get paid for treating Millie.
531338 - ref SDS 0 J43I
531340 - ..
531341 - [On 070124 Pam reported Kaiser eventually made contact with a
531342 - Medicare representative; after several hours of discussions
531343 - throughout the day, Kaiser submitted an authorization account
531344 - number to UCSF. ref SDS 30 6K3L
531345 -
531346 -
531347 -
531349 - ..
5314 -
5315 -
5316 - 1143
5317 -
531701 - Kaiser Authorization Office Coordinating with UCSF Resolve Problem
531702 -
531703 -
531704 - Millie received ref DRT 1 0001 from Michelle responding to Millie's
531705 - letter, ref DIT 1 0001, submitted to Kaiser earlier this morning, per
531706 - above. ref SDS 0 C48M
531708 - ..
531709 - Michelle at Kaiser says to Millie...
531710 -
531711 - 1. Someone from our authizoration dept was to call Lisa in the
531712 - billing dept of UCSF this am to straighten every thing out.
531713 - Pam in OA spoke with the medicare office yesterday, she was
531714 - going to explain everything to Lisa at UCSF. Medicare
531715 - should pay for all care at UCSF. (labs, xrays to be done at
531716 - Kaiser as ususal), ref DRT 1 S56F
531718 - ..
531719 - 2. Hope all goes well, ref DRT 1 P56M,
531721 - ..
531722 - The rest of Michelle's letter that relates to blood tests is reported
531723 - below. ref SDS 0 GK5B
531725 - ..
531726 - Michelle's explanation seems to align with communications on 061230,
531727 - when the primary care physician advised Doctor Rugo at UCSF that
531728 - Kaiser would pay for standard of care, and that labs and testing would
531729 - be done at Kaiser. ref SDS 14 3X6K
531730 -
531731 - [On 070124 Pam reported Kaiser eventually made contact
531732 - with a Medicare representative; after several hours of
531733 - discussions throughout the day, Kaiser was able to
531734 - submit an authorization account number to UCSF.
531735 - ref SDS 30 6K3L
531737 - ..
531738 - [On 070125 Jackie reported that UCSF did not receive an
531739 - authorization from Kaiser, and that Lisa in UCSF's
531740 - Business Office spent 6 hours talking to Medicare to
531741 - establish that UCSF would be paid for treating Millie.
531742 - ref SDS 31 4Y62
531743 -
531744 -
531745 -
531747 - ..
5318 -
5319 -
5320 - 1226
5321 -
532101 - Millie submitted ref DIT 2 0001 thanking Michelle for the update with
532102 - evident expectations of resolving policy conflicts in time to avoid
532103 - delaying treatment, per above. ref SDS 0 575F
532105 - ..
532106 - Millie's response to Michelle at Kaiser says...
532107 -
532108 - 1. Great work reported in your letter today that Kaiser
532109 - and UCSF are reaching agreement so that I can get
532110 - treatment. ref DIT 2 0001
532112 - ..
532113 - Millie's letter on blood work continues below. ref SDS 0 SY7N
532115 - ..
532116 - Concern about delaying treatment is elevated by blood test report
532117 - today that CA 15-3 has jumped back up again to 67, after falling to
532118 - 56, per below. ref SDS 0 GK5B
532119 -
532120 -
532122 - ..
5322 -
5323 -
5324 - 1633
5325 -
532501 - UCSF Frustrated Kaiser Has Not Submitted Authorization
532502 -
532503 - Margaret called from UCSF Medical Center.
532504 -
532505 - Thanked Margaret again for excellent work facilitating Millie's
532506 - meetings with Doctor Benz, most recently on 060821. ref SDS 11 SM6M
532508 - ..
532509 - Margaret said that she has been assisting Jackie today trying to get
532510 - Millie's account set up for treatment tomorrow at UCSF. The work plan
532511 - is for treatment on a clinical study with cetuximab and carboplatin,
532512 - which was prescribed by Millie's primary care physician at Kaiser as
532513 - the best treatment for Millie's condition of advancing IBC metastatic
532514 - disease reported by Kaiser on....
532515 -
532516 - Kaiser examination................. 061201, ref SDS 12 025H
532517 - Kaiser examination................. 061208, ref SDS 13 025H
532518 - Kaiser examination................. 070105, ref SDS 17 025H
532520 - ..
532521 - Margaret explained that UCSF has still not received authorization
532522 - documentation signed by Millie's primary care physician on 070119.
532523 - She said the discussions between UCSF and Kaiser reported by the
532524 - primary care physician at Kaiser in a letter on 070122, ref SDS 27
532525 - PN4I, and further cited by Michelle this morning, per above,
532526 - ref SDS 0 PR3V, have not been successful.
532528 - ..
532529 - Margaret seemed to explain that either she, or someone in Doctor
532530 - Rugo's office called Medicare today to attempt in good faith to carry
532531 - out suggestions developed from discussions with Kaiser for
532532 - establishing entitlement to payment through Medicare for USCF to
532533 - provide Millie's treatment prescribed by the primary care physician in
532534 - the meeting at Kaiser on 070105. Margaret related that the UCSF
532535 - person was on hold waiting to speak with someone at Medicare in the
532536 - manner requested by Kaiser for about 20 minutes, then the line was
532537 - dropped, and the standard phone company message was given to call
532538 - back. UCSF called Medicare back, and the same thing happened. As a
532539 - result, UCSF has nothing that establishes the revenue stream on this
532540 - transaction.
532541 -
532542 - [On 070124 Pam reported Kaiser had similar experience, but
532543 - eventually made contact with a Medicare representative, and after
532544 - several hours of discussions, Kaiser submitted an authorization
532545 - account number to UCSF. ref SDS 30 6K3L
532547 - ..
532548 - [On 070125 Jackie reported UCSF did not receive an authorization
532549 - from Kaiser, and that Lisa in UCSF's Business Office spent 6 hours
532550 - talking to Medicare to establish that UCSF would be paid for
532551 - treating Millie. ref SDS 31 4Y62
532553 - ..
532554 - Margaret was frustrated. She asked if Kaiser has a Patient Advocate
532555 - that Millie could notify for assistance, since UCSF has been unable
532556 - to make progress.
532558 - ..
532559 - Kaiser has several "assistant" roles...
532560 -
532561 - 1. Physician Assistant...... 050215, ref SDS 7 DL6J
532562 - 2. Medical Assistant........
532563 - 3. Patient Advocate......... 990913, ref SDS 2 N48H
532564 - 4. Records Assistant........
532565 - 5. Technical Assistant......
532566 - 6. Engineering Assistant....
532568 - ..
532569 - Margaret advised that UCSF has not written a letter to Kaiser stating
532570 - what they require to treat Millie. She seemed to indicate that
532571 - normally everything is handled by conversation.
532573 - ..
532574 - Margaret advised that UCSF has scheduled Millie for treatment
532575 - tomorrow. If UCSF writes a letter stating treatment is delayed until
532576 - UCSF receives a particular document from Kaiser, then Millie can
532577 - notify her doctor precisely what is needed to resolve the problem.
532579 - ..
532580 - Margaret wants Millie to write the letters coordinating with Kaiser,
532581 - and seemed to indicate that nobody at UCSF has time to write a letter
532582 - on this, because Kaiser already knows what is needed. She feels
532583 - Millie can contact her doctor without anything from UCSF, and say she
532584 - heard in a telephone call that treatment is denied because UCSF needs
532585 - something from Kaiser, but the patient does not know what it is except
532586 - for the general phrase, "authorization number."
532588 - ..
532589 - There was discussion that UCSF has spent about 20 minutes in this
532590 - telephone call with Millie. Writing a letter to Millie confirming the
532591 - problem, which Millie can then submit to Kaiser would take 5 mintues.
532593 - ..
532594 - Margaret feels that writing a letter telling the patient why treatment
532595 - is refuesed and what UCSF requires to proceed is either not necessary
532596 - or is otherwise objectionable for some reason.
532598 - ..
532599 - Thanked Margaret for the call, and advised a letter will be sent to
532600 - the doctor at Kaiser to report understandings Margaret has presented.
532601 -
532602 -
532603 -
532604 -
5327 -
SUBJECTS
Treatment Delay IBC Cascading Out of Control CA 15-3 Rising Kaiser D
5903 -
5904 - 1702
590501 - ..
590502 - Cascading Out of Control IBC Requires Treatment Authorization for UCSF
590503 - Treatment Needed Avoid IBC Cascading Out of Control Like Before
590504 - Doctor Notified Authorization for UCSF to Treat Millie Not Received
590505 -
590506 - Millie submitted ref DIT 3 0001 to the primary care physician at
590507 - Kaiser explaining the problem Margaret presented, per above.
590508 - ref SDS 0 3S3J, and clarifying the favorable understanding set out in
590509 - Millie's earlier letter to Michelle, earlier today, also, per above.
590510 - ref SDS 0 EG7K
590511 -
590512 - 1. I just got a call from Margaret Rubino, who
590513 - works for Doctor Rugo at UCSF. ref DIT 3 0001
590515 - ..
590516 - 2. Margaret said UCSF has not received the
590517 - authorization you signed on January 19th, and
590518 - that UCSF requires an authorization account
590519 - number from Kaiser. Margaret said
590520 - collaboration between Kaiser and UCSF admin
590521 - staff on these matters has not been successful,
590522 - and so my doctor needs to facilitate Kaiser's
590523 - referral to UCSF. ref SDS 0 3S3J, ref DIT 3
590524 - AK5N
590526 - ..
590527 - 3. I am concerned that CA 15-3 is rising without
590528 - treatment since 061201, similar to before.
590529 - Missing the current window for treatment at
590530 - UCSF will require another PET/CT test causing
590531 - increased costs and further delay. ref DIT 3
590532 - NK6L
590534 - ..
590535 - Michelle at Kaiser reports in a letter today that CA 15-3 increased
590536 - again, now to 68, per below. ref SDS 0 GK5B This eliminates prior
590537 - improvement reported on 070110. ref SDS 19 087J
590539 - ..
590540 - Citation "...similar to before." references treatment ended on 041021,
590541 - and was denied on 041104 because Kaiser discovered pulmonary embolism
590542 - in Millie's CT test the day before. Rather than continue treatment
590543 - with Taxol, which posed no evident risk, ref SDS 4 LP7F, there were
590544 - various delays for over 2 months, until treatment was resumed on
590545 - 050105. ref SDS 6 0001 By then IBC was cascading out of control, as
590546 - discussed in the case study on patient history listed on 041230.
590547 - ref SDS 5 P19O At that time, CA 15-3 continued to rise above 100
590548 - while being treated with AC until treatment was switched on 050329.
590549 - ref SDS 8 0001 A few weeks after starting treatment with Taxotere and
590550 - capecitabine (Xeloda), IBC rash dramatically subsided, and CA 15-3
590551 - dropped back to 67. ref SDS 9 0001
590553 - ..
590554 - High medical costs from mistakes reported on 990912, ref SDS 1 0001,
590555 - occur from delaying authorization that requires another medical test,
590556 - because treatment delayed from 061230 when primary care physician and
590557 - Doctor Rugo agreed Millie would get treatment at UCSF, ref SDS 14
590558 - 3X6K, and planning began on 070101 for Millie seeing Doctor Rugo.
590559 - ref SDS 15 E23P There was plenty of time then to work on
590560 - authorization and use the PET/CT test on 061227.
590562 - ..
590563 - Millie's letter to primary care physician continues...
590564 -
590565 - 4. Can you please complete these arrangements, or
590566 - let me know what I can do to provide the
590567 - authorization number to UCSF? ref DIT 3 LK7H
590569 - ..
590570 - [On 070124 Millie writes another letter requesting
590571 - Arlette to assist in resolving authorization issues,
590572 - ref SDS 30 YF8U, and then leaves town for short
590573 - vacation. ref SDS 30 KX9H
590575 - ..
590576 - [On 070124 Jackie called and left message for Millie
590577 - indicating problem has been resolved; UCSF wants Millie
590578 - to have another PET/CT test before starting treatment.
590579 - ref SDS 30 PQ4Q
590581 - ..
590582 - [On 070124 Pam reported Kaiser had difficulty contacting
590583 - Medicare, similar to Margaret's report today, per above,
590584 - ref SDS 0 MW5Y, but eventually made contact with a
590585 - Medicare representative, and after several hours of
590586 - discussions, Kaiser was able to submit an authorization
590587 - account number to UCSF. ref SDS 30 6K3L
590588 -
590589 -
590590 -
590592 - ..
5906 -
5907 -
5908 - 1717
5909 -
590901 - Doctor on Vacation Cannot Resolve Authorization Issue Until Next Week
590902 -
590903 - Margaret at UCSF asked Millie to send a letter to the doctor on
590904 - coordinating referral, per above. ref SDS 0 L43U After Millie sent a
590905 - letter to the doctor, also, per above, ref SDS 0 J94L, Kaiser reported
590906 - that the primary care physician is on vacation until 070129.
590908 - ..
590909 - Evidently, UCSF planning for Millie to start treatment tomorrow cannot
590910 - be achieved, and so treatment of progressing disease is delayed at
590911 - this time indefinetly.
590913 - ..
590914 - [On 070124 Millie sent a letter to Arlette at Kaiser explaining
590915 - background ref SDS 30 YF8U, and asking for assistance.
590916 - ref SDS 30 BA9Y
590918 - ..
590919 - [On 070124 Arlette expedited coordination of resolution.
590920 - ref SDS 30 UE4O
590922 - ..
590923 - [On 070124 UCSF notifies Millie referral problem solved; orders
590924 - another CT test because treatment has been delayed too long to
590925 - use the last CT test on 061227. ref SDS 30 PQ4Q
590927 - ..
590928 - [On 070126 substitute doctor orders CT test requested by UCSF
590929 - for Millie's treatment. ref SDS 32 Z24H
590930 -
590931 -
590932 -
590933 -
590935 - ..
5910 -
5911 -
5912 - 1722
5913 -
591301 - UCSF Delays Treatment Pending Kaiser Authorization Account Number
591302 -
591303 - Jackie called.
591304 -
591305 - Jackie explained that she and others at UCSF have spent a lot of time
591306 - and effort to make arrangements for Millie to get treatment tomorrow,
591307 - but this has not worked out. She asked Margaret to call earlier and
591308 - explore possible ways to assist Kaiser with pending authorization.
591310 - ..
591311 - Commended Margaret's past work helping Millie get a 2nd opinion from
591312 - Doctor Benz, and that her call today was professional and helpful in
591313 - all respects, per above. ref SDS 0 MW4H
591315 - ..
591316 - Jackie explained that normally patients arrive at UCSF with a document
591317 - that authorizes payment for treatment. Dealing with Kaiser works
591318 - differently, and this causes delays and frustrations all around.
591320 - ..
591321 - Asked about getting the name of the document UCSF wants so that Millie
591322 - can asked her doctor about it? Considered prospects again of Jackie,
591323 - Doctor Rugo, or someone at UCSF writing a letter explaining treatment
591324 - is denied and what is required to provide treatment, as discussed with
591325 - Margaret earlier. ref SDS 0 J96N
591327 - ..
591328 - Jackie feels that UCSF should not have to explain the problem in
591329 - writing. She asked if Millie has contacted Kaiser following the call
591330 - from Margaret earlier today, per above? ref SDS 0 J98F
591332 - ..
591333 - Reviewed Millie's letter to the primary care physician, ref SDS 0
591334 - J94L, submitted to Kaiser after Margaret's call about 40 minutes ago,
591335 - per above. ref SDS 0 J94L
591337 - ..
591338 - Jackie explained that under the circumstances with no authorization
591339 - from Kaiser and Medicare, Millie cannot get treatment tomorrow at
591340 - UCSF, as planned originally on 070117, ref SDS 23 5S85, and then
591341 - revised during the meeting at UCSF on 070119. ref SDS 26 AS5H Doctor
591342 - Rugo wants to establish with documentation from Kaiser and Medicare
591343 - that neither UCSF nor Millie will get stuck with the bill, which is
591344 - covered by Millie's health care entitlements and insurance premiums.
591345 - We considered prospects of getting treatment on Thursday or Friday if
591346 - by some miracle difficult issues presented today are resolved in time?
591348 - ..
591349 - [On 070124 Pam reported Kaiser eventually made contact with a
591350 - Medicare representative, and after several hours of
591351 - discussions, Kaiser was able to submit an authorization account
591352 - number to UCSF. ref SDS 30 6K3L
591353 -
591354 -
591355 -
591356 -
591357 -
5914 -
SUBJECTS
Default Null Subject Account for Blank Record
6003 -
600401 - ..
600402 - CT Test Monitor Patient to Quickly Switch from Ineffective Treatment
600403 - Drug Trial Protocol Waiver Possible Use CT Test on 061227
600404 - Patient Better Served by Test Data Close to Treatment Start Date
600405 -
600406 - Jackie seemed to indicate having discussed Millie's case with Doctor
600407 - Rugo today.
600409 - ..
600410 - The doctor apparently gave the impression to Jackie that UCSF could
600411 - probably obtain a protocol waiver for Millie to get treatment this
600412 - week under the PET/CT test on 061227, since the requirements would
600413 - only be exceeded by a few days. However, the doctor feels Millie
600414 - would be better served by having another PET/CT test if treatment is
600415 - delayed until next week. Jackie understands from Doctor Rugo that
600416 - besides drug trial study requirements, tests closer in time to the
600417 - date of starting treatments provide better diagnostics on patient
600418 - benefits; so that, if treatment is not effective, the doctor can
600419 - switch the patient to another regimen in time to prevent disease from
600420 - cascading out of control.
600422 - ..
600423 - The primary care physician has cautioned strongly throughout Millie's
600424 - care for breast cancer, and particularly with respect to IBC, that
600425 - accurate data to take action in time to avoid cancer from spinning out
600426 - of control is a critical criteria of treatment strategy, shown by case
600427 - study on 041230. ref SDS 5 P19O
600428 -
600429 - [On 070124 Jackie leaves message that the doctor wants Millie
600430 - have another CT test. ref SDS 30 PQ4Q
600432 - ..
600433 - [On 070125 Doctor Rugo orders updated CT test to begin new
600434 - treatments at UCSF; request CT test for pulmonary embolism.
600435 - ref SDS 31 Z24H
600436 -
600437 -
600438 -
600440 - ..
600441 - Patient Help Expedite Kaiser Authorization Process
600442 - UCSF Suggests Patient Notify Kaiser Background Authorization Problem
600443 -
600444 - Jackie suggested that Millie submit a more detailed account of
600445 - background on the scope and urgency of the authorization problem for
600446 - getting Millie into treatment.
600448 - ..
600449 - Explained that Millie got a response to her letter 10 minutes ago
600450 - after talking to Margaret, per above. ref SDS 0 MW4H Kaiser reports
600451 - that Millie's doctor is on vacation until next week. ref SDS 0 LP4L
600452 - There may be nothing more that can be done until Millie's primary care
600453 - physician returns from vacation.
600455 - ..
600456 - Jackie said she will work the problem further tomorrow, and let Millie
600457 - know about progress.
600459 - ..
600460 - Millie will consider asking Arlette to get involved. She has been a
600461 - strong support for good management at Kaiser, illustrated by the
600462 - record on 060809. ref SDS 10 3J4O
600463 -
600464 - [On 070124 Millie sent a letter to Arlette at Kaiser explaining
600465 - background ref SDS 30 YF8U, and asking for assistance.
600466 - ref SDS 30 BA9Y
600468 - ..
600469 - [On 070124 Arlette expedited resolution with Kaiser's
600470 - Authorization Department. ref SDS 30 UE4O
600472 - ..
600473 - [On 070124 Pam reported Kaiser eventually made contact with a
600474 - Medicare representative; after many hours of discussion a
600475 - solution was arranged; Kaiser submitted an authorization
600476 - account number to UCSF. ref SDS 30 6K3L
600477 -
600478 -
600479 -
600481 - ..
6005 -
6006 -
6007 - 1801
6008 -
600801 - Millie Implements Deferred Vacation Plans to Leave Town for Few Days
600802 -
600803 - After Jackie's call explaining UCSF demand for administrative details
600804 - from Kaiser, per above, ref SDS 0 J94O, Millie was very disappointed
600805 - and despondent that all the work the past month to expedite treatment
600806 - has failed. She decided that to relieve emotional tension,
600807 - frustration and anger, rather than sit around the house waiting for
600808 - phone calls and hearing endless explanations of treatment delayed
600809 - because people in various departments at Kaiser, UCSF and Medicare
600810 - failed to perform, got mixed up, or lost documents, she might as well
600811 - take several days vacation previously planned, as reported on 070116,
600812 - ref SDS 22 VQ3G, but were then cancelled to accomodate cancer
600813 - treatments, which UCSF scheduled for tomorrow on 070124, as reported
600814 - on 070118, ref SDS 24 FA60, but are now on hold, or cancelled because
600815 - Kaiser and UCSF do not agree, as reported by Michelle, per above,
600816 - ref SDS 0 3S3J, and confirmed by Jackie. ref SDS 0 J43I It's another
600817 - mess.
600819 - ..
600820 - [On 070124 Millie travels to Seattle after treatment is delayed;
600821 - implements original plan. ref SDS 30 KX9H
600822 -
600823 -
600824 -
600825 -
6009 -
SUBJECTS
Blood Test Performed Treatment Clinical Study Cetuximab Carboplatin
7003 -
700401 - ..
700402 - Laboratory Blood Test Performed Today Per Doctor's Order
700403 -
700404 - Follow up ref SDS 27 AS6M, ref SDS 26 AS6M.
700406 - ..
700407 - Millie's letter from above, ref SDS 0 YF6Y, to Michelle at Kaiser
700408 - continues...
700409 -
700410 - 3. As well, per your call yesterday, I went to Kaiser at 0600 this
700411 - morning and got additional blood tests ordered by [my doctor]
700412 - yesterday that meet UCSF requirements for me to start
700413 - treatment. ref SDS 27 LX6V, ref DIT 1 CQ6F
700415 - ..
700416 - 4. When time permits, I need the report on the blood test which
700417 - Kaiser submitted to UCSF OA 070119. It should now show CA 15-3
700418 - diagnostic, as noted in the letter last week to Kaiser.
700419 - ref SDS 26 0Z9P, ref DIT 1 XQ7I
700421 - ..
700422 - Michelle did not have time to discuss submitting blood test reports,
700423 - during the call yesterday. ref SDS 27 Z73H
700424 -
700425 - [On 070130 Millie scheduled for treatment at UCSF on
700426 - 070201. ref SDS 33 MP4H
700427 -
700428 - [On 070131 UCSF requests another blood test before starting
700429 - treatment on 070201. ref SDS 34 NZ4N
700431 - ..
700432 - The test today corrects mistakes in the test on 070118, ref SDS 24
700433 - HZ41, which were reported the next day on 070119 during a meeting at
700434 - UCSF.
700436 - ..
700437 - Millie's letter to Michelle at Kaiser concludes...
700438 -
700439 - 5. Thanks also to Arlette for coordinating everything.
700440 -
700441 -
700443 - ..
7005 -
7006 -
7007 - 1143
7008 -
700801 - CA 15-3 68 Cancer Marker Big Rise Elevates Need for Timely Treament
700802 -
700803 -
700804 - Michelle at Kaiser letter to Millie continues...
700805 -
700806 - 3. I am putting in the mail today (which will go out tomorrow)
700807 - a copy of the labs from 1/18. The CA 15-3 was 68. UCSF
700808 - already has these results. I will check the computer this
700809 - afternoon to see if your results from today are back yet.
700810 - If they are I will fax to UCSF. If not Arlette will fax
700811 - them tomorrow am. ref DRT 1 0001
700813 - ..
700814 - CA 15-3 rising from 56 to 68 loses most of the improvement reported on
700815 - 070110. ref SDS 19 087J Rising cancer marker underscores urgency of
700816 - starting treatment, ended on 061201. Millie cited rising CA 15-3 in
700817 - letter to primary care physician on authorizing treatment at UCSF, per
700818 - above. ref SDS 0 SX5W
700820 - ..
700821 - Millie responded to Michelle at Kaiser....
700823 - ..
700824 - This letter continues from the section on delayed treatment.
700825 - ref SDS 0 EG8T
700826 -
700827 - 2. If it is not too much touble, rather than mail
700828 - documents to me, can you cut and past the lab report on
700829 - blood tests (both today and last week) in an email so I
700830 - don't have to type everything over again? If you send
700831 - me a printed document, then I have to key it in.
700832 - ref DIT 2 2W5M
700834 - ..
700835 - 3. Arlette and [my doctor] for example use cut and past to
700836 - send the Medical Chart report on meetings, CT test
700837 - reports, ect., via email. ref DIT 2 HW6I
700839 - ..
700840 - 4. I realize that sometimes tasks which sound fast and
700841 - easy turn out to be difficult and time consuming, and I
700842 - don't want to add to your work. But, if it is just as
700843 - fast for you to send the blood test results by return
700844 - email that would save me a lot of time and effort to
700845 - manage the record. ref DIT 2 TW6N
700847 - ..
700848 - Michelle submitted the blood test report in a follow up letter.
700849 - During this time the email program failed. ref SDS 29 6180 Various
700850 - solutions were attempted, resulting in using a Netscape upgrade called
700851 - variously Mozilla or Thunderbird. ref SDS 29 L49K
700853 - ..
700854 - Eventually, email functionality was restored.
700856 - ..
700857 - This process resulted in losing some correspondence. One was
700858 - Michelle's letter that submitted the blood test report.
700860 - ..
700861 - Since UCSF ordered another blood test, and blood was drawn this
700862 - morning, per above, ref SDS 0 AS6M, will try to avoid asking Michelle
700863 - to resubmit the blood test, since it was incomplete. If the test
700864 - today is complete, rather than just supplementing the prior test, then
700865 - the report the test today will be adequate for patient history.
700866 -
700867 -
700868 -
700869 -
700870 -
700871 -
700872 -
7009 -