CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 22 0000. ref SDS 21 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - On 071024 UCSF was asked for total claim against Millie, ref SDS 21
040902 - EP4W, and to explain basis of charges, ref SDS 21 EP5T  UCSF was asked
040903 - for ideas on making interim payment based on Kaiser standard copayment
040904 - amounts. ref SDS 21 EP6P  There was an offer to meet and discuss
040905 - solutions. ref SDS 21 EP6S
040907 -  ..
040908 - On 071026 UCSF billing irregularities cause concern about making
040909 - payments. ref SDS 22 X18J
040911 -  ..
040912 - On 071026 UCSF demanded payment in 1 week, ref SDS 22 SU5V, based on
040913 - Millie's plan in a letter on 071010 to make a payment. ref SDS 22 SU3N
040914 - UCSF intended to hold Millie to her "word" in the letter on 071010,
040915 - ref SDS 22 SU53, with promise to pay back money Millie does not really
040916 - owe, after Kaiser pays UCSF. ref SDS 22 SU5Y  This was determined to
040917 - be incorrect.  Millie notified UCSF the next day 071011 of finding
040918 - irregularities in UCSF billings, and planned to discuss with the
040919 - doctor in a meeting on 071018. ref SDS 22 VX9O
040920 -
040921 -            [On 071031 Millie receives notice dated 071026 UCSF plans
040922 -            referral to collection agency for payment of $202.65 on
040923 -            Kaiser referral account 12493370, ref SDS 24 KK4I, revised
040924 -            070830, ref SDS 6 4P8K, and revised again on 070917,
040925 -            ref SDS 9 MK4H; no indication of UCSF collection efforts
040926 -            against Kaiser; separate notice dated 071027 and also
040927 -            received 071031 UCSF says Millie's treatment for cancer
040928 -            ordered by Kaiser will be terminated if UCSF does not
040929 -            receive payment of $202.65. ref SDS 24 KM8J
040931 -  ..
040932 - A major problem managing the UCSF account is getting someone to
040933 - represent UCSF who has authority to determine UCSF's total claim and
040934 - explain billings.
040936 -  ..
040937 - Submitted letter responding to UCSF letter yesterday on 071026...
040938 -
040939 -    1.  Subject: Payment on Account
040940 -        Date: Sat, 27 Oct 2007 04:37:01 -0700
040951 -         ..
040952 -    2.  Responding to your letter yesterday on 071026, ref SDS 22 K49J,
040953 -        which replied to the letter to UCSF a few days ago on 071024.
040954 -        ref SDS 21 UW5J
040956 -         ..
040957 -    3.  Concern in your letter about assurances for UCSF to get paid
040958 -        are correct.  Millie is working hard on this.  Review shows
040959 -        Millie consistently meets commitments [responding to UCSF
040960 -        complaint about holding Millie to her "word," ref SDS 22 SU53,
040961 -        as follows...
040962 -
040963 -           [On 071128 Kaiser Appeals Committee approved payment for
040964 -           Millie's care on referral to UCSF. ref SDS 26 JZ5R
040966 -         ..
040967 -    4.  Millie's letter to UCSF on 071010 presented plans to make
040968 -        interim payment based on UCSF's letter on 070912. ref SDS 16
040969 -        UW5J
040971 -         ..
040972 -    5.  Mil further asked [in the letter to UCSF on 071010] about a new
040973 -        invoice received on 071006 that seems to duplicate charges
040974 -        previously paid for doctor services as part of the spreadsheet
040975 -        in the UCSF letter dated 070912. ref SDS 16 HZ6S
040977 -         ..
040978 -    6.  Your reply later in the day on 071010 disclosed another
040979 -        business unit was billing additional charges, and indicated
040980 -        UCSF was reviewing the account to answer Millie's request for a
040981 -        total of all charges to date. ref SDS 16 OH89
040982 -
040983 -           [On 071101 Nancy Baird with MGBS called to request
040984 -           assistance with billing for professional services; she
040985 -           plans to contact Paula about facilitating UCSF billings for
040986 -           referral from Kaiser. ref SDS 25 5R5H
040988 -         ..
040989 -    7.  Millie wrote the next day on 071011 saying she was confused by
040990 -        UCSF multi-colored invoices, which had not been explained
040991 -        during 10 months of care by UCSF, and that she planned to ask
040992 -        the doctor  for input to clarify things during a meeting on
040993 -        October 18th. ref SDS 18 K65P
040995 -         ..
040996 -        Cut Loose Kaiser Fails Support Patient Referred to UCSF
040997 -
040998 -    8.  On the 18th, the doctor brought up billings, and seemed
040999 -        troubled recalling 10 months ago in January she drew from
041000 -        communication with Kaiser that Millie had been "cut loose" to
041001 -        fend for herself. ref SDS 20 W23I
041003 -         ..
041004 -    9.  Millie was not part of those discussions between UCSF and
041005 -        Kaiser in January.  She relied on Kaiser to make arrangements
041006 -        according to EOC requirements.  Millie was told on 070119 that
041007 -        this was done, confirmed by discussion at UCSF on 070130.
041008 -        ref SDS 3 LY9H
041010 -         ..
041011 -   10.  At no time was she notified about "self-referral,"
041012 -        "coinsurance" or that she would incur any expense since Kaiser,
041013 -        as with past practice, was paying costs not covered by the
041014 -        clinical trial. [reported on 061230. ref SDS 1 3X6K]
041016 -         ..
041017 -   11.  Millie was therefore shocked to begin receiving billings 8
041018 -        months later dated back to January.  Concern in UCSF's letter
041019 -        yesterday [on 071026] about "holding" folks to their word,
041020 -        ref SDS 22 SU53, is therefore a central issue.
041021 -
041022 -            [On 071128 Kaiser Appeals Committee approved payment for
041023 -            Millie's care on referral to UCSF. ref SDS 26 JZ5R
041025 -         ..
041026 -   12.  During the meeting on 070130 there was discussion of meeting to
041027 -        develop a referral coordination plan.  As you can see, this was
041028 -        rejected on grounds that Kaiser and UCSF would manage the work
041029 -        using established procedures with experienced professionals.
041030 -        ref SDS 3 AQ5L
041032 -         ..
041033 -   13.  Millie's case coordinator brought this up again on 070222, and
041034 -        UCSF indicated there wasn't enough time, wasn't necessary, and
041035 -        so on. ref SDS 4 VK5N
041037 -         ..
041038 -   14.  Of course, no one was aware at that time there was a billing
041039 -        issue, at least by the people meeting with Millie.
041040 -
041042 -         ..
041043 -        Meeting Coordination Referral Clinical Trials Billings
041044 -        Clinical Trial Referral Meeting Determine Terms of Payment
041045 -
041046 -   15.  Now, 8 months later, events have shown that a coordination
041047 -        referral meeting is needed.  Since Kaiser, for the time being,
041048 -        has "cut loose" Millie to fend for herself, she must perform
041049 -        management that Kaiser fails to perform.
041051 -  ..
041052 - On 070904 Millie suggested a coordination plan and explanation of
041053 - billings, the total owed to date and the basis of charges. ref SDS 7
041054 - 6R3R
041056 -  ..
041057 - Letter to UCSF continues...
041059 -         ..
041060 -        Single Point of Contact between UCSF and Patient
041061 -
041062 -   16.  The first step is to designate a single point of contact who
041063 -        has authority to commit UCSF, so that when Millie asks what is
041064 -        the total owed to date, that person has authority to cull UCSF
041065 -        business units and present a complete picture.  So far, we've
041066 -        had a moving target that prevents Millie from formulating her
041067 -        claim against Kaiser.  There has to be a way to nail down all
041068 -        charges for past work, and explain the various invoices,
041069 -        including what is paid by Medicare, and paid by the clinical
041070 -        trial. [requested in Millie's letter on 071010. ref SDS 16
041071 -        HZ5U]
041072 -
041073 -            [On 071031 UCSF threatens assignment to collection agency
041074 -            example of "moving target" for billings to Millie.
041075 -            ref SDS 24 LJ3N
041077 -         ..
041078 -   17.  Meeting to explain billing procedures is a normal part of
041079 -        business.  [referral coordination meeting was requested during
041080 -        meeting at UCSF on 070830, ref SDS 6 VT7G; letter yesterday on
041081 -        071024 offered to meet to discuss issues. ref SDS 21 EP6S]
041082 -
041084 -         ..
041085 -        Call to Arrange Meeting for Coordination Referral Plan
041086 -
041087 -   18.  Sometimes people get so tangled in minutia and rising internal
041088 -        tensions that communication suffers because positions calcify.
041089 -        I apologize for not being more timely addressing UCSF concerns
041090 -        for getting paid.  I'll call on Monday about setting up a
041091 -        meeting and agreeing to interim payment that does not
041092 -        jeopardize Millie's efforts to get Kaiser back in the proper
041093 -        role.
041094 -
041095 -            [On 071029 called and UCSF refused to schedule referral
041096 -            coordination meeting to explain billing procedures, because
041097 -            despite not having worked with UCSF previously, the patient
041098 -            should have known that UCSF bills for clinical trial
041099 -            services with multiple business units and delays sending
041100 -            invoices for 9 months, ref SDS 23 WS3J
041102 -             ..
041103 -            [On 071029 letter to Robin Hanson in the UCSF accounting
041104 -            department requests that UCSF schedule referral
041105 -            coordination meeting to explain billing procedures.
041106 -            ref SDS 23 446F
041108 -             ..
041109 -            [On 071031 Millie receives notice dated 071026 UCSF plans
041110 -            referral to collection agency for payment of $202.65 on
041111 -            Kaiser referral account 12493370, ref SDS 24 KK4I, revised
041112 -            070830, ref SDS 6 4P8K, and revised again on 070917,
041113 -            ref SDS 9 MK4H; no indication of UCSF collection efforts
041114 -            against Kaiser; separate notice dated 071027 and also
041115 -            received 071031 UCSF says Millie's treatment for cancer
041116 -            ordered by Kaiser will be terminated if UCSF does not
041117 -            receive payment of $202.65. ref SDS 24 KM8J
041118 -
041119 -
041120 -
041121 -
041122 -
041123 -
041124 -
041125 -
041126 -
0412 -