CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 6 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Yesterday afternoon, Millie received a letter from Doctor Johnson
040902 - advising that instead of filing a referral for Millie's treatment to
040903 - recover from the 8th relapse of cancer, and further instead of filing
040904 - an apeal with Member Services of Doctor Mason's verbal refusal to
040905 - authorize the doctor's referral for Millie's treatment, Doctor Johnson
040906 - sent all correspondence on this matter to Doctor Mason, including the
040907 - draft appeal, which Doctor Johnson had requested from the patient for
040908 - him to file with Member Services, reported on 090519 1536, ref SDS 4
040909 - 5K7H
040911 -  ..
040912 - The doctor cited ignorance of government regulations for failure to
040913 - prescribe treatment for Millie urgently needed for Millie's recovery.
040914 - reported on 090519 1536, ref SDS 4 VK9H
040916 -  ..
040917 - Yesterday afternoon, Millie sent a response to Doctor Johnson's
040918 - letter, and asking Kaiser to prescribe treatment for her 8th relapse
040919 - of cancer as called out by Kaiser's standard of care for oncology.
040920 - 090519 1613. ref SDS 5 TY3X   Millie asked the doctor to call about
040921 - scheduling treatment. ref SDS 5 TY4W
040923 -  ..
040924 - Since the doctor has not called, this morning, called and left a
040925 - message for Doctor Johnson to discuss when Millie needs to start
040926 - treatment in order for care to be effective recovering from the 8th
040927 - relapse of cancer.  Need to know how much time can be invested to
040928 - assist Kaiser with regulatory issues, as noted in the letter
040929 - yesterday, reported on, 090519 1613, ref SDS 5 TX4W
040930 -
040931 -        [On 090520 1710 notified medical team having leaving telephone
040932 -        messages trying to schedule urgent treatment for Millie in time
040933 -        to be effective, and which have not been returned for several
040934 -        days. ref SDS 11 ZF5R
040936 -         ..
040937 -        [On 090528 1228 Millie notifies Kaiser Member Services
040938 -        Claims Resolution Department that email is the only means
040939 -        of communication with Kaiser, because everybody is too busy
040940 -        to return calls. ref SDS 13 4N8U
040942 -  ..
040943 - Barbara the receptionist said that she talked to Doctor Johnson.  He
040944 - said to say he would be in meetings the rest of the day and could not
040945 - return the call today.
040947 -  ..
040948 - Barbara asked if the practice manager, Paula Vanicola could help?
040950 -  ..
040951 - Asked to talk to Paula.
040953 -  ..
040954 - Barbara then said that Paula is also in meetings.
040955 -
040956 -        [On 090520 1113 Millie received a letter from Doctor Johnson
040957 -        saying Kaiser "offers" Millie Gemzar or Navelbine, and
040958 -        confirmed these treatments are high risk of failure and causing
040959 -        harm for Millie's patient profile, and said Member Services and
040960 -        Outside Referrals interpret clinical trials for Millie to
040961 -        recover from 8th relapse of cancer. ref SDS 7 UC9G
040963 -         ..
040964 -        [On 090520 1137 Millie submitted a response to Kaiser and
040965 -        presenting understandings to Doctor Johnson that in the meeting
040966 -        at Kaiser on 090515 the doctor advised Millie that Gemzar and
040967 -        Navelbine were not appropriate for Millie's patient profile,
040968 -        and that he would get in trouble from an audit for prescribing
040969 -        these treatments for Millie at this stage of her care.
040970 -        ref SDS 8 SR5W
040972 -         ..
040973 -        [On 090520 1153 Paula in Kaiser Member Services Case
040974 -        Resolution Center received Millie's letter, and advised
040975 -        that Kaiser requires "evidenced-based" medical practice;
040976 -        and recommends expedited claims to assist primary care
040977 -        doctor prescribing treatment in time to be effective for
040978 -        Millie to recover from the 8th relapse of cancer.
040979 -        ref SDS 9 4M9G
040981 -         ..
040982 -        [On 090520 1203 Pamela Powell reviewing Millie's claim for
040983 -        Kaiser to prescribe treatment based on best evidence showing
040984 -        effective care for Millie to recover from 8th relapse of
040985 -        cancer. ref SDS 10 9595
040987 -         ..
040988 -        [On 090521 0902 Pamela called back and said Expedited Claims
040989 -        cannot rule on Millie's request for support, because Millie's
040990 -        case falls through the cracks; Expedited claims cannot deny
040991 -        Millie's request for the doctor to prescribe treatment, but do
040992 -        not want to issue an order for a Kaiser doctor to prescribe
040993 -        care for a patient, and so Expedited Claims called Doctor
040994 -        Johnson to encourage resolution, and also submitted the case to
040995 -        Member Services in Pleasenton. ref SDS 12 UD5H
040996 -
040997 -
040998 -
040999 -
041000 -
041001 -
041002 -
041003 -
041004 -
0411 -