CONTACTS 

SUBJECTS
CA 15-3 520 Kaiser Lab 100511 Cancer Marker Rises Highest Patient Hi

0803 -
0803 -    ..
0804 - Summary/Objective
0805 -
080501 - Follow up ref SDS 25 0000. ref SDS 24 0000.
080502 -
080503 -
080504 -
080505 -
080507 -  ..
0806 -
0807 -
0808 - Background
0809 -
080901 - On 100501 1037 Millie sent a letter to the medical team asking for a
080902 - work plan to recover from the 11th relapse, caused by UCSF medical
080903 - mistakes providing radiation services on referral from Kaiser, which
080904 - have caused her cancer to spread. ref SDS 14 F25O
080906 -  ..
080907 - On 100501 2017 Millie received letter from Doctor Rugo saying she will
080908 - communicate with Doctor Johnson at Kaiser on the work plan for Millie
080909 - to recover from the 11th relapse of cancer. ref SDS 15 HH4I
080911 -  ..
080912 - On 100502 0140 Millie responds to Doctor Rugo's letter reporting
080913 - commitment to communicate with Doctor Johnson at Kaiser on the work
080914 - plan for Millie to recover from 11th relapse of cancer. ref SDS 16
080915 - HH4I
080917 -  ..
080918 - On 100502 0140 Millie responds to Doctor Rugo's letter reporting
080919 - commitment to communicate with Doctor Johnson at Kaiser on the work
080920 - plan for Millie to recover from 11th relapse of cancer. ref SDS 16
080921 - HH4I
080923 -  ..
080924 - On 100503 1522 Millie notifies medical team of difficulty using Kaiser
080925 - secure email; asks about getting treatment with Abraxane chemotherapy
080926 - scheduled for Wednesday, 100505, or switching to a "targeted" agent.
080927 - ref SDS 17 HH4I
080929 -  ..
080930 - On 100503 1945 Millie receives letter from Kaiser saying to continue
080931 - with Abraxane chemotherapy for 2 more treatments, and then after 2
080932 - weeks without treatment the doctor will discuss next steps in a
080933 - meeting at Kaiser. ref SDS 18 HH4I
080935 -  ..
080936 - On 100503 2338 Millie notifies medical team that Kaiser guidance will
080937 - be implemented to get 2 treatments that complete 3rd cycle of
080938 - Abraxane, ref SDS 19 HH4I,
080940 -  ..
080941 - On 100504 1609 Sara, Practice Manager for Breast Care Clinic, called
080942 - to confirm Doctor Rugo plans to call Kaiser about developing a work
080943 - plan for Millie to recover from 11th relapse of cancer caused by UCSF
080944 - medical mistakes. ref SDS 20 NT5N  Sara asked Millie if she has other
080945 - concerns; Millie concerned about getting response from medical team on
080946 - comparing treatment trade-offs pending for a year. ref SDS 20 FK9I
080947 - Reviewed UCSF medical mistakes, and pending issues. ref SDS 20 NT99
080948 - Sara investigating patients right to use public domain email for
080949 - expediting communications with medical team. ref SDS 20 ZV6M
080951 -  ..
080952 - On 100505 0411 Millie letter to medical team on UCSF investigating
080953 - medical mistakes to expedite recovery from 11th relapse of cancer.
080954 - ref SDS 21 NT5N
080956 -  ..
080957 - On 100511 0800, Millie had a blood test at Kaiser in Martinez.
080958 - ref SDS 22 AS5H
080960 -  ..
080961 - On 100513 1422 called Arlette this morning to get results of the
080962 - cancer marker for Millie's blood test on 100511, because these results
080963 - are not posted on Kaiser's Knowledge Mangement system for customers.
080964 - ref SDS 22 NK7F  Arlette called later with results.  Millie received a
080965 - letter in the afternoon from Arlette confirming her cancer marker has
080966 - increased to an all time high, saying CA 15-3 520. ref SDS 23 IZ7N
080968 -  ..
080969 - On 100527 0217 completed writing a claim to Kaiser Claims Resolution
080970 - Department, asking Paula to secure immedicate treatment for Millie
080971 - because her cancer marker shows he disease has increased to the
080972 - highest level in patient history, and that recovery for Millie from
080973 - medical mistakes UCSF made providing radiation medical services on
080974 - referral from Kaiser, and notifying Kaiser and UCSF that Millie's
080975 - recovery requires all reasonable and necessary efforts and costs, and
080976 - is not limited by benefits of her insurance policy, and medicare law.
080977 - ref SDS 24 IZ7N
080979 -  ..
080980 - On 100528 1031 Millie received letter from Julin at Medicare answering
080981 - Millie's letter yesterday, requesting Medicare assistance directing
080982 - Kaiser to provide reasonable and necessary care for Millie to recover
080983 - from UCSF medical mistakes. ref SDS 0 4W5F  Called Medicare to
080984 - expedite Millie's care. ref SDS 0 JS9H  Talked to Cherry and Beth who
080985 - explained Medicare work plan for processing Millie's complaint.
080986 - ref SDS 0 P28U
080987 -
080988 -
080989 -
080991 -  ..
0810 -
0811 -
0812 - Progress
0813 -
0814 -
081401 - Letter from Jullin says...
081402 -
081403 -    1.  Subject: RE: Claim Recovery Medical Mistakes Need Immediate Treatment 11th Relapse Cancer CA 15-3 520
081404 -        Date: Fri, 28 May 2010 09:51:02 -0400
081411 -         ..
081412 -        Thank you for your inquiry.
081414 -         ..
081415 -    2.  I do not work on the Kaiser account anymore.  I will forward
081416 -        your message to my coworker, Amma, who handles the Kaiser
081417 -        account to review and get back to you.  Should you need to
081418 -        speak with her, you  may contact her at 415-744-3617.
081420 -  ..
081421 - Jullin responds to Mille's letter earlier this morning asking for
081422 - support to recover from medical mistakes, reported on 100528 0322.
081423 - ref SDS 25 QQ6N
081424 -
081425 -            [On 100528 1031 telecon Cherry and Beth at Medicare report
081426 -            CMS processing Millie's request for support on her claim
081427 -            against Kaiser and UCSF. ref SDS 0 4295
081434 -             ..
081435 -            [On 100603 0449 Millie thanked Jullin in a letter to
081436 -            medical team for taking immediate action to support the
081437 -            Medicare customer by asking Kaiser to report on progress
081438 -            responding to Millie's claim. ref SDS 28 IX4P
081440 -  ..
081441 - Jullin's letter for Medicare continues...
081442 -
081443 -    3.  Lastly, it is suggested to not include your SSN in the future,
081444 -        since our email are not secured.  Thanks!
081446 -  ..
081447 - Julie makes a good point about supressing account numbers in unsecure
081448 - email.  The challenge is to balance the need for timely review in
081449 - order to take action in time to be effective, agains the risk that one
081450 - and only one letter will be grabbed by electronic identity theft
081451 - experts, and cause Millie harm.
081453 -  ..
081454 - Millie's patient history has a lot of public domain email, which does
081455 - not expose account numbers, her last name, her address, nor any other
081456 - personal identify information.  Of course her emal address is exposed,
081457 - which could lead folks to access her email.  In 9-years working with
081458 - the medical team and transmitting thousands of communications, there
081459 - is no evidence anyone has stolen or otheriwse misused Millie's email
081460 - address.  Therefore, 99.9999% of letters on Millie's case management
081461 - between Kaiser, UCSF, and a small amount with Medicare and others does
081462 - not expose Millie to any significant risk of electronic identify
081463 - theft.
081465 -  ..
081466 - In this case, Julie was able to access Millie's account immediately
081467 - and determine background showing that she (Jullin) had been successful
081468 - assisting Kaiser in 2007 on a similar matter.  Knowledge of context
081469 - guided Jullin's timely follow up this morning, per below.
081471 -  ..
081472 - Jullin could have called the patient to get information.  The patient
081473 - could have called Jullin to provide more information.  The record here
081474 - shows that compared to providing account date with email, using the
081475 - telephone this takes a long time, and is enormously frustrating,
081476 - reported by Doctor Rugo at UCSF.  On 080403, Doctor Rugo asked Millie
081477 - to use email for case management coordinating her care with Kaiser,
081478 - because email is fast and accurate, and calling and playing "phone
081479 - tag" takes too much time and invites error from misinterpreting
081480 - mission critical facts that causes irreperable harm to patient health.
081481 - ref SDS 2 4U9O
081482 -
081483 -
081484 -
081486 -  ..
0815 -
0816 -
0817 - 1121
0818 -
081801 - Called for Amma as shown in Jullin's letter, per above, ref SDS 0
081802 - 4W5F, and received this morning...
081803 -
081804 -                    415-744-3617
081806 -  ..
081807 - Paul answered.
081809 -  ..
081810 - Paul advised that Amma took the day off, because Monday is a holiday,
081811 - and some people are also taking Friday off to have a 4-day weekend.
081813 -  ..
081814 - Asked to speak with Jullin, about Millie's letter this morning, which
081815 - she sent to Amma, per above. ref SDS 0 4W5F
081817 -  ..
081818 - Paul said Jullin is now a supervisor.  He proposed transferring the
081819 - call to Amma's backup today, Cherry.
081821 -  ..
081822 - Agreed to try Cherry, and asked how to connect with someone, since ths
081823 - matter is urgent?
081825 -  ..
081826 - Paul said he is sure Cherry is available to take the call.
081828 -  ..
081829 - Paul transferred the call to Cherri, but there was no answer.
081831 -  ..
081832 - Called Paul back.
081834 -  ..
081835 - He is looking something up.
081837 -  ..
081838 - Paul asks for Millie's medicare number, which is the social security
081839 - account.
081841 -  ..
081842 - Paul is investigating.
081844 -  ..
081845 - He will walk this issue to Cherry's desk, and have her call back today
081846 - about Millie's claim.
081848 -  ..
081849 - Explained Cherry needs to first review Millie's claim against Kaiser,
081850 - submitted this morning to Jullin, reported on 100528 0322. ref SDS 25
081851 - QQ6N, and which Jullin then forwarded to Amma, per Jullin's letter
081852 - received, shown above, ref SDS 0 4W5F  So, Cherry needs to retrieve
081853 - Jullin's letter to Amma in order to read the claim.
081855 -  ..
081856 - After Cherry reviews Millie's claim, she can call with Medicare's work
081857 - plan to secure a solution for Millie that is equitable for Medicare,
081858 - UCSF, and Kaiser based on the facts in Millie's patient history.
081859 -
081860 -
081861 -
081862 -
081864 -  ..
0819 -
0820 -
0821 - 1430
0822 -
082201 - After returning from getting gasoline for the trip to pick up Millie
082202 - at the airport this evening, there was a message from Cherry at
082203 - Medicare.
082205 -  ..
082206 - Cherry asked to call back for urgent support...
082207 -
082208 -                   415 744 3768
082209 -
082210 -
082212 -  ..
0823 -
0824 -
0825 - 1440
0826 -
082601 - Called Cherry...
082602 -
082603 -                415 744 3768
082605 -  ..
082606 - Left message for her call.
082607 -
082608 -
082610 -  ..
0827 -
0828 -
0829 - 1452
0830 -
083001 - Cherry Castaneda called back.
083002 -
083003 - Beth Simon joined the call on a speaker phone in the conference room.
083005 -  ..
083006 - Cherry advised that she received the letter Jullin sent to Amma early
083007 - this morning, per above, ref SDS 0 QQ6N, that includes Millie's letter
083008 - to Jullin, submitted to Medicare CMS early this morning on 100528
083009 - 0322. ref SDS 25 QQ6N, and with Millie's claim filed with Kaiser,
083010 - shown in the record yesterday on 100527 0217. ref SDS 24 IZ7N
083012 -  ..
083013 - Cherry explained steps Medicare CMS has taken so far...
083014 -
083015 -    1.  Medicare reports OA 0651 am this morning receiving Millies
083016 -        claim filed with Kaiser yesterday on 100527 0217. ref SDS 24
083017 -        IZ7N, and transmitted to Medicare with Millie's letter this
083018 -        morning, reported in the record on 100528 0322, ref SDS 25
083019 -        QQ6N, and as shown by Jullin's letter responding to Millie, per
083020 -        above. ref SDS 0 4W5F
083022 -         ..
083023 -    2.  Medicare assembled a team this morning to immediately review
083024 -        Millie's claim.
083026 -         ..
083027 -    3.  Medicare determined from the claim that Millie requests
083028 -        immediate treatment targeted to her cancer necessary and
083029 -        reasonable for recovering from medical mistakes caused by UCSF
083030 -        providing radiation services on referral from Kaiser, and that
083031 -        UCSF and Kaiser agreed in a letter dated on or about 090616,
083032 -        that Millie's next treatment would be with PARP or equal, shown
083033 -        in the first para of the claim, reported on 100527 0217.
083034 -        ref SDS 24 IZ7N
083036 -         ..
083037 -    4.  Medicare printed Millie's 32-page claim, and transmittal letter
083038 -        to Medicare.
083040 -         ..
083041 -    5.  Medicare sent Millie's claim via fax to Paula in Kaiser's
083042 -        Claims Resolution Department asking for Kaiser's response to
083043 -        Millie's request for urgent, necessary and reasonable care to
083044 -        recover from UCSF medical mistakes.
083046 -         ..
083047 -    6.  Medicare (Cherry) called Kaiser Claims Resolutions Department
083048 -        to verify receipt of Millie's claim sent with fax, and to
083049 -        discuss Kaiser's timely response.  Paula and other agents
083050 -        responsible for Millie's account, did not report for work this
083051 -        morning, because people are taking a 4-day vacation due to
083052 -        Memorial Holiday on Monday.
083054 -         ..
083055 -    7.  As of 3p (1500) this afternoon, Kaiser has not responded to
083056 -        Medicare's request for Kaiser's work plan to respond to
083057 -        Millie's claim.
083059 -         ..
083060 -    8.  Medicare CMS (Cherry, Beth, and/or Amma) will call Paula at
083061 -        Kaiser on 100601, Tuesday morning, for Kaiser's response to
083062 -        Millie's claim.
083063 -
083064 -            [On 100602 1046 at 1659, Eileen called and advised that
083065 -            Millie's claim for recovery from medical mistakes has been
083066 -            submitted to Kaiser's Claims Resolution Department for
083067 -            review. ref SDS 27 I36J
083069 -         ..
083070 -    9.  Medicare CMS (Cherry, Beth, and/or Amma) will call Rod on
083071 -        100601, Tuesday, to advise on Kaiser's response to Millie's
083072 -        claim, as determined in step 8. ref SDS 0 538J
083073 -
083074 -            [On 100608 1521 called CMS - Cherry and Beth - to follow up
083075 -            on coordinating with Kaiser to review Millie's claim.
083076 -            ref SDS 29 036C
083078 -         ..
083079 -   10.  Medicare CMS will submit a form for Millie to sign authorizing
083080 -        quality care audit on Millie's care at Kaiser.
083082 -         ..
083083 -        Quality care review should reconcile patient records of 180
083084 -        medical mistakes, reported in case study on 040416, ref SDS 1
083085 -        GN7J, with Kaiser's internal records, showing no reports of
083086 -        medical mistakes.
083088 -  ..
083089 - Beth explained during the call today, that Kaiser does not bill UCSF
083090 - for individual procedures, but rather Kaiser is paid a flat monthly
083091 - rate for Millie's care.
083093 -  ..
083094 - Cherry said Millie's Medicare coverage changed recently to a different
083095 - "plan."
083097 -  ..
083098 - Millie's claim agaist Kaiser is not affected by changes in Medicare
083099 - "plan" coverage, because Millie seeks recovery from injuries caused by
083100 - medical mistakes getting radiation treatment at UCSF on referral from
083101 - Kaiser, reported on 100527 0217, ref SDS 24 IZ7N
083103 -  ..
083104 - We reviewed the insurance problem for Medicare...
083105 -
083106 -        1.  Medicare pays Kaiser a flat rate to provide Millie's health
083107 -            care, which includes recovery from medical mistakes.
083108 -
083109 -        2.  Kaiser refuses to demand necessary and reasonable recovery
083110 -            from UCSF to repair Millie's injuries caused by UCSF
083111 -            medical mistakes providing radiation treatment on referral
083112 -            from Kaiser, as presented in Millie's statement of claim in
083113 -            the record on 100527 0217, ref SDS 24 IZ7N, and for the
083114 -            purpose of Kaiser receiving unjust economic benefit from
083115 -            good business relations with UCSF, reported by Claims
083116 -            Resolution Department on 091112, ref SDS 12 A593, in return
083117 -            for conveying unjust economic benefits to UCSF.
083119 -             ..
083120 -        3.  Since Kaiser cannot bill Medicare, and refuses to bill
083121 -            UCSF, Kaiser refuses necessary and reasonable care for
083122 -            Millie to recover from UCSF medical mistakes, by limiting
083123 -            treatment to insurance benefits paid by Medicare, and which
083124 -            are not designed, nor intended to provide recovery from
083125 -            medical mistakes.
083127 -             ..
083128 -        4.  Kaiser and UCSF failure to provide necessary and reasonable
083129 -            care for recovery from medical mistakes conveys an unjust
083130 -            economic benefit (enrichment), and ordering chemotherapy
083131 -            solely for the purpose of avoiding necessary and reasonable
083132 -            recovery from medical mistakes, worsens Millie's health,
083133 -            and causes painful, agonizing complications, and for which
083134 -            Kaiser received payment from Medicare, and UCSF avoids
083135 -            accountability.
083137 -             ..
083138 -        5.  Kaiser and UCSF collaborating to delay effective treatment,
083139 -            and providing instead treatment known to be ineffective and
083140 -            painful causes torture that discourages patient will to
083141 -            live with effective treatment based on best-evidence.
083142 -            Forcing patient death for economic benefit unjustly
083143 -            enriches Kaiser and UCSF, since "good business relations"
083144 -            do not justify withholding care to recover from medical
083145 -            mistakes for over a year.
083147 -  ..
083148 - Beth said Medicare (Cherry or Amma) will call Millie Tuesday morning
083149 - after they discuss with the Claims Resolution Department Kaiser's
083150 - response to Millie's claim, and after Millie returns from meeting at
083151 - 0830, with Doctor Johnson at Kaiser, see step 9. ref SDS 0 RB5G
083152 -
083153 -
083154 -
083155 -
083156 -
083157 -
083158 -
083159 -
083160 -
0832 -