Hold On Now

Thursday September 17, 2020

Kaiser Foundation Health Plan of Colorado
Kaiser Permanente c/o
Escalated Complaints
2500 S Havana St
Aurora, CO 80014
Attn: Rocio B.
Grievance and Appeal Administrator
303 338 3757

For your convenience this document is published on the Internet at:
http://www.mkgappraisal.com/letter2020_07.htm

For reference:
Your letter to me, dated 9/09/20, and
My letter to Kaiser Mail Order Pharmacy dated 8/20/20

I received your letter in the US Mail at 6 PM on Monday 9/14/20. I called you the next day, Tuesday 9/15/20 at 10:17 AM, and left a voice message. I asked you to call me, and so far, I have not received any response.

Your letter states that the “Kaiser Permanente Grievance and Appeals Administration” is committed to a deadline of “no later than 30 calendar days of receipt”. I presume that the purpose of the first sentence of your letter is to establish 9/4/20 as the start of the 30 day time limit. Your letter states that the case will be completed based on all the information available at the time of the review.

This letter will confirm that my voice message asked you to put the “grievance process review” ON HOLD until we have a chance to talk.

At the time I wrote my letter dated 8/20/20, I was concerned that there was an urgent need for action. I was about to run out of the medicine I need.

I intentionally limited the focus of the letter to the need for the Mail Order Pharmacy to immediately ship 60 tablets to me, and if need be, we could argue about any disagreements afterward.

Did you read the letter?

I now have the medicine. I received the 60 tablets at 11:00 AM on Tuesday 9/8/20. As stated in the letter, 8/31/20 was the first day that I went without my medicine. A total of 8 days went by with no medicine.

From my point of view, what you call “my concern” is now ended -- in the sense that I am now taking my medicine every morning. You did not define what YOU consider to be “my concern”. I am concerned about that. I expressly forbid any attempt to read my mind.

There is, of course, an investigation that needs to happen. But I need more time before I am ready to properly organize and then express my thoughts. And I know, with 100% certainty, that you and your crew there at the Grievance and Appeals Administration are not going to be able to read my mind. I say it again. I expressly forbid any attempt to read my mind.

Please don’t do anything rash until October 15th, 2020. I do expect that I will have something more to say on this subject.

Under the heading of:

“Your rights as a Kaiser Permanente Member”, it says that I have the right to: “Review, amend, and correct my medical records as needed.” I understand this requires some interpretation, but I take it to mean I am entitled to ask the following:

The opening sentence of your letter states:

This letter is written to acknowledge receipt of your concern on September 04, 2020, that will be reviewed through the Health Plan Grievance process.

I object to the phrase “receipt of your concern”. It is vague and non-specific. I want you to be specific. You received a copy of my letter to Kaiser Mail Order Pharmacy dated 8/20/20.

I Offer:

This letter is written to acknowledge receipt of, a copy of, your letter to Kaiser Mail Order Pharmacy dated 8/20/20, which will be treated by us as a “concern”. We received the letter on September 04, 2020. The “concern” will be reviewed through the Health Plan Grievance process.

If you don’t like my wording, I am willing to consider your suggestion(s). You ought to be willing to admit that you received a copy of my letter. Right?

Thank you for your prompt attention.

Philip G Rice
11268 E Linvale Dr
Aurora, CO 80014
720-282-3376
phil.rice@mkgappraisal.com
Health Record Number 427582802, DOB 4/25/53
temp/kaiser_web/letter_01/rocio_02.docx

Kaiser Response dated 10/05/20.

-- End of Letter --

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