CONTACTS 

SUBJECTS
Kaiser Agrees Pay Millie's Treatment  Cinical Trials on Referral to

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5403 -    ..
5404 - Summary/Objective
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540501 - Follow up ref SDS 76 0000. ref SDS 74 0000.
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5408 - Discussion
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540901 - Kaiser Appeals Committee Approved Payment Millie's Clinical Trial UCSF
540902 -
540903 - Follow up ref SDS 76 TH8L, ref SDS 74 TH8L.
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540905 - Received ref DRT 1 0001 from Kaiser confirming understandings from
540906 - Paul's call on 071128, ref SDS 73 TH8L, and follow up call with Paula
540907 - yesterday on 071203 0926. ref SDS 76 KJ9G
540909 -  ..
540910 - Paul says in her letter today...
540911 -
540912 -    1.  The Kaiser Foundation Health Plan's Regional Appeals
540913 -        Committee/1 has met to review your request for Health Plan
540914 -        coverage for services provided to Ms Buck by UCSF Medical
540915 -        Center from Janury 30, 2007 to present.  After careful review
540916 -        of the relevant information, a decision has been made to
540917 -        approve your request. ref DRT 1 0001
540919 -         ..
540920 -    2.  Ms Buck will be issuedan authoirzed referral by the Kaiser
540921 -        Permanente Walnut Creek Outside referral Departmetn for
540922 -        coverage of her Medicare Co-insurance for services related to
540923 -        the Triple Negative Study, Clinical Trial at UCSF.  The
540924 -        conditions of this authorization are that Ms Buck is required
540925 -        to receive an evaluation by the Plan's Oncology Physician every
540926 -        three months to determine her progress in the study.
540927 -        ref DRT 1 F26S
540929 -         ..
540930 -    3.  A check will be sent directly to UCSF Medical Center within the
540931 -        next few weeks. ref DRT 1 F27R
540933 -         ..
540934 -    4.  What if you have a quality of care complaint?  If you are
540935 -        concerned about the quality of care you have received, you may
540936 -        also file a complaint with the local Quality Improvmeent
540937 -        Organization, Lumetra (800 841 1602).  Quality Improvement
540938 -        Organizations are groups of doctors and health professionals
540939 -        that monitor the quality of care provided to Medicare
540940 -        beneficiaries.  The Quality Improvement Organization review
540941 -        process is designed to stop any improper practices. ref DRT 1
540942 -        F27V
540944 -         ..
540945 -    5.  You may also file a quality complaint with Kaiser Foundation
540946 -        Health Plan.  We will review your complaint and notify you in
540947 -        writing of our conclusion within 30 days, unless we notify you
540948 -        that additional time is necessary.  This process is separate
540949 -        from the appeal process. ref DRT 1 F27N
540951 -         ..
540952 -    6.  If you have any further questions please feel free to call me
540953 -        at (925) 924 6887, Monday through Fricay between 8:30 am and
540954 -        5:00 pm. ref DRT 1 F28W
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