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Carewise Health louisville kentucky JC GIBSON

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Jun 15th, 2018
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  1. Gibson, JC JC.Gibson@shps.comHide
  2. To Gibson, JC JC.Gibson@shps.com, VLVinch VLVinch@aol.com
  3. Cc Bauscher, Jon Jon.Bauscher@shps.com, Hennessy, Amanda Amanda.Hennessy@shps.com, Lee, David David.Lee@shps.com
  4. Slideshow
  5. Vicky, I wanted to check in with you. We are still working with our vendors to get your whole picture. Please allow our team till Monday afternoon to call you.
  6.  
  7.  
  8.  
  9. JC
  10.  
  11.  
  12.  
  13. From: Gibson, JC
  14. Sent: Monday, November 14, 2011 6:45 PM
  15. To: 'VLVinch@aol.com'
  16. Cc: Bauscher, Jon; Hennessy, Amanda; Lee, David
  17. Subject: RE: MD's Notes
  18.  
  19.  
  20.  
  21. Ms. Vinch, I wanted to let you know that I’m taking a personal interest in your case and we are working with Matrix, our vendor, to better understand the circumstances from which your complaint arises. Immediate resolution and response may be somewhat slowed as today I received your formal complaint as filed through the Kentucky Labor Cabinet. This filing requires a formal response to them as a part of the process.
  22.  
  23.  
  24.  
  25. Although I may be limited in how I can respond to you, I’m personally handling this investigation. Please give me 2 days to complete my investigation. Also, you can direct all future communication to me. Thanks,
  26.  
  27.  
  28.  
  29. JC Gibson
  30.  
  31. EVP, Human Resources
  32.  
  33. SHPS Inc
  34.  
  35. 502.326.4570
  36.  
  37. jc.gibson@shps.com
  38.  
  39.  
  40.  
  41.  
  42.  
  43.  
  44.  
  45. From: Mehrotra, Rishabh
  46. Sent: Monday, November 14, 2011 4:49 PM
  47. To: Gibson, JC
  48. Subject: FW: MD's Notes
  49.  
  50.  
  51.  
  52.  
  53.  
  54.  
  55.  
  56. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  57. Sent: Monday, November 14, 2011 4:45 PM
  58. To: Blanca.Parra@matrixcos.com
  59. Cc: Hillerich, Laura; Tatum, Mark; Susan.Long@ky.gov; Mehrotra, Rishabh
  60. Subject: Re: MD's Notes
  61.  
  62.  
  63.  
  64. Hi Blanca -
  65.  
  66. Firstly - if you could answer ALL of the questions in this email it would be greatly appreciated.
  67.  
  68.  
  69.  
  70. I did receive Matrix's letter just a short while ago via fax.
  71.  
  72.  
  73.  
  74. It states, " "Based on the medical records from Dr. Wood for the period of October 01, 2011 through November 23, 2011... "
  75.  
  76.  
  77.  
  78. How is this possible when today is only November 14th?
  79.  
  80.  
  81.  
  82. SECONDLY, please respond to my Question #2 (third request) - I need a coherent explanation as to how Matrix & SHPS can deny my disability as of October 7th when the FMLA was approved?
  83.  
  84.  
  85.  
  86. It appears that Matrix/SHPS is simply stalling paying the disability benefits. I hope that is not the case for all of our sakes. It also appears that no one there either completely read or understood the information that was provided to you.
  87.  
  88.  
  89.  
  90. What is your Supervisor's name, please?
  91.  
  92.  
  93.  
  94. Thank you,
  95.  
  96. Vicky
  97.  
  98.  
  99.  
  100.  
  101.  
  102.  
  103.  
  104. In a message dated 11/14/2011 3:21:36 P.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  105.  
  106. Vicky,
  107.  
  108. I had not sent you the denial letter as I was waiting on an approval from my supervisor so I am faxing over right now.
  109.  
  110. Thank you
  111.  
  112.  
  113.  
  114. Blanca Parra
  115. Integrated Claims Examiner
  116. Matrix Absence Management, Inc.
  117. Phone: 602.866.2333 ext. 56022
  118.  
  119. Fax: 602.866.9707
  120. blanca.parra@matrixcos.com
  121. www.matrixcos.com
  122. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  123.  
  124.  
  125.  
  126. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  127. Sent: Monday, November 14, 2011 11:37 AM
  128. To: Blanca Parra
  129. Cc: laura.hillerich@shps.com; mark.tatum@shps.com; Susan.Long@ky.gov; rishabh.mehrotra@shps.com
  130. Subject: Re: MD's Notes
  131.  
  132.  
  133.  
  134. Good Morning, Blanca -
  135.  
  136.  
  137.  
  138. Per your email dated November 8, 2011, you'd indicated you would be faxing me the denial information of my Short Term Disability claim as well as outlining the appeals process. To date I have received nothing.
  139.  
  140.  
  141.  
  142. I'd also asked how Matrix/SHPS can deny the disability claim when the FMLA was approved - can someone please explain this to me?
  143.  
  144.  
  145.  
  146. To reiterate, I need from Matrix and/or SHPS:
  147.  
  148.  
  149.  
  150. 1. What is the appeals process.
  151.  
  152. 2. A coherent explanation as to how Matrix & SHPS can deny my disability as of October 7th when the FMLA was approved.
  153.  
  154.  
  155.  
  156. Thanking you in advance. I hope your week goes well,
  157.  
  158.  
  159.  
  160. Best Regards,
  161.  
  162. Vicky Vinch
  163.  
  164.  
  165.  
  166.  
  167.  
  168.  
  169.  
  170. In a message dated 11/9/2011 6:52:32 P.M. Eastern Standard Time, VLVinch@aol.com writes:
  171.  
  172. Blanca, I appreciate everything you've done. According to this letter I have from SHPS dated 10/29/11 (the nation's leading provider of benefits administration solutions), my COBRA coverage will cost $468.62 per month. According to Anthem (below) my coverage had expired on October 13th (a week before I was notified by SHPS via telephone that my employment had been terminated although Matrix indicated my FMLA was approved). The $272.54 you've so graciously agreed to send will not even cover my COBRA. I am now out of my hypertension medications as well (yes, I also have malignant hypertension). So basically I am cooked. But thanks for trying. You've been wonderful.
  173.  
  174.  
  175.  
  176.  
  177.  
  178. You have a good evening & stay well,
  179.  
  180. Vicky
  181.  
  182.  
  183.  
  184.  
  185.  
  186.  
  187.  
  188. In a message dated 11/9/2011 5:51:34 P.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  189.  
  190. Vicky,
  191.  
  192. I do apologize it was mailed 11/08/11.
  193.  
  194. Thank you
  195.  
  196.  
  197.  
  198. Blanca Parra
  199. Integrated Claims Examiner
  200. Matrix Absence Management, Inc.
  201. Phone: 602.866.2333 ext. 56022
  202.  
  203. Fax: 602.866.9707
  204. blanca.parra@matrixcos.com
  205. www.matrixcos.com
  206. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  207.  
  208.  
  209.  
  210. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  211. Sent: Wednesday, November 09, 2011 3:25 PM
  212. To: Blanca Parra
  213. Cc: laura.hillerich@shps.com; mark.tatum@shps.com; Susan.Long@ky.gov
  214. Subject: Re: MD's Notes
  215.  
  216.  
  217.  
  218. It only takes a week for mail to get here from Matrix. If it was mailed October 8th, 2011, I suggest you re-check my address, please, because I have not received it.
  219.  
  220.  
  221.  
  222. In a message dated 11/9/2011 5:20:24 P.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  223.  
  224. Hello Vicky,
  225.  
  226. I have submitted the denial to my supervisor for approval once approved I will fax it to the fax number that you provided. Also your benefits for the period of 09/3011 thru 10/07/11 in the amount of $272.54 were mailed to you on 10/08/11.
  227.  
  228. Thank you
  229.  
  230.  
  231.  
  232. Blanca Parra
  233. Integrated Claims Examiner
  234. Matrix Absence Management, Inc.
  235. Phone: 602.866.2333 ext. 56022
  236.  
  237. Fax: 602.866.9707
  238. blanca.parra@matrixcos.com
  239. www.matrixcos.com
  240. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  241.  
  242.  
  243.  
  244. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  245. Sent: Wednesday, November 09, 2011 2:06 PM
  246. To: Blanca Parra
  247. Cc: laura.hillerich@shps.com; mark.tatum@shps.com; Susan.Long@ky.gov
  248. Subject: Re: MD's Notes
  249.  
  250.  
  251.  
  252. I just received a phone call from my primary care physician's office (Blankenbaker Primary Care) - they say they received a fax requesting info about this disability request (I"m guessing it was from Matrix) and I attempted to make an appointment as they requested. However, when I informed them I did not have the copay plus the $20 he charges to fill out the forms they indicated they could not do it, although I have been a patient of this MD for over 5 years and owe them no money whatsoever.
  253.  
  254.  
  255.  
  256. FYI.
  257.  
  258.  
  259.  
  260. Thanks.
  261.  
  262.  
  263.  
  264.  
  265.  
  266.  
  267.  
  268. In a message dated 11/8/2011 1:10:50 P.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  269.  
  270. Vicky,
  271.  
  272. Yes I will fax it to the number you have provided.
  273.  
  274.  
  275.  
  276. Blanca Parra
  277. Integrated Claims Examiner
  278. Matrix Absence Management, Inc.
  279. Phone: 602.866.2333 ext. 56022
  280.  
  281. Fax: 602.866.9707
  282. blanca.parra@matrixcos.com
  283. www.matrixcos.com
  284. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  285.  
  286.  
  287.  
  288. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  289. Sent: Tuesday, November 08, 2011 11:08 AM
  290. To: Blanca Parra
  291. Cc: laura.hillerich@shps.com; mark.tatum@shps.com; Susan.Long@ky.gov
  292. Subject: Re: MD's Notes
  293.  
  294.  
  295.  
  296. Please fax it to me. Fax # is 708 290 5196.
  297.  
  298.  
  299.  
  300. How is Matrix able to justify the below decision when I also received FMLA approval?
  301.  
  302.  
  303.  
  304. Matrix has now gone against my physicians recommendations, and this will now make nearly five weeks with no income whatsoever. I have repeatedly asked you what it was you needed, and you have repeatedly indicated you received nothing from my physician when their documentation clearly shows it was sent & timestamped.
  305.  
  306.  
  307.  
  308. I find it even more curious that Matrix represents a "healthcare" company which boasts giving employees accurate and reliable service. Please ask "your supervisor" if she considers this accurate and reliable?
  309.  
  310.  
  311.  
  312. I now cannot even pay for my COBRA. I cannot pay for my prescription renewals. I have no homeowners insurance now or auto insurance.
  313.  
  314.  
  315.  
  316. You tell me I was "terminated" *while* on FMLA, on October 19, 2011, retroactive to October 12th, with NO indication from Matrix that my FMLA supposedly expired?
  317.  
  318.  
  319.  
  320. Vicky
  321.  
  322.  
  323.  
  324. In a message dated 11/8/2011 12:41:05 P.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  325.  
  326. Vicki,
  327.  
  328. I will provide the appeal process in your denial letter. Once my supervisor has review and approved the denial request I will create your denial letter and mail it out to you.
  329.  
  330. Thank you
  331.  
  332.  
  333.  
  334. Blanca Parra
  335. Integrated Claims Examiner
  336. Matrix Absence Management, Inc.
  337. Phone: 602.866.2333 ext. 56022
  338.  
  339. Fax: 602.866.9707
  340. blanca.parra@matrixcos.com
  341. www.matrixcos.com
  342. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  343.  
  344.  
  345.  
  346. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  347. Sent: Tuesday, November 08, 2011 10:10 AM
  348. To: Blanca Parra
  349. Cc: laura.hillerich@shps.com
  350. Subject: Re: MD's Notes
  351.  
  352.  
  353.  
  354. Blanca, what is the appeal process, please?
  355.  
  356.  
  357.  
  358. In a message dated 11/8/2011 11:51:54 A.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  359.  
  360. Good morning Vicki,
  361.  
  362. The medical review has been completed and benefits will be approved from 09/23/11 thru 10/07/11. Benefits beyond 10/08/11 will be denied as self reports do not support, your labs were normal range. I will complete claim so that benefit go out for the period that has been approved.
  363.  
  364. Thank you
  365.  
  366.  
  367.  
  368. Blanca Parra
  369. Integrated Claims Examiner
  370. Matrix Absence Management, Inc.
  371. Phone: 602.866.2333 ext. 56022
  372.  
  373. Fax: 602.866.9707
  374. blanca.parra@matrixcos.com
  375. www.matrixcos.com
  376. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  377.  
  378.  
  379.  
  380. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  381. Sent: Tuesday, November 08, 2011 7:07 AM
  382. To: Blanca Parra
  383. Cc: laura.hillerich@shps.com
  384. Subject: Fwd: MD's Notes
  385.  
  386.  
  387.  
  388. Can anyone PLEASE tell me what you need???
  389.  
  390.  
  391.  
  392. From: Blanca.Parra@matrixcos.com
  393. To: VLVinch@aol.com
  394. Sent: 11/3/2011 3:10:14 P.M. Eastern Daylight Time
  395. Subj: RE: MD's Notes
  396.  
  397.  
  398.  
  399. Vicki,
  400.  
  401. I have received your medical notes I will submit for a medical review and will provide an update once completed.
  402.  
  403. Thank you
  404.  
  405.  
  406.  
  407. Blanca Parra
  408. Integrated Claims Examiner
  409. Matrix Absence Management, Inc.
  410. Phone: 602.866.2333 ext. 56022
  411.  
  412. Fax: 602.866.9707
  413. blanca.parra@matrixcos.com
  414. www.matrixcos.com
  415. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  416.  
  417.  
  418.  
  419. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  420. Sent: Thursday, November 03, 2011 11:43 AM
  421. To: Blanca Parra
  422. Subject: MD's Notes
  423.  
  424.  
  425.  
  426. Hello Blanca -
  427.  
  428.  
  429.  
  430. Attached please find the MD's notes from my endocrinologist, Dr. Donald D. Wood. When we'd previously spoken you'd indicated this is all that you'd needed in order to process my disability claim.
  431.  
  432.  
  433.  
  434. Anything you can do to expedite this claim would be greatly appreciated. I have not had any income in a month. I no longer have heat in my home - tomorrow night it is expected to reach the 30's. I was unable to make my mortgage payment last week. My homeowners & car insurance are both overdue. I have no paper products left in my house whatsoever so you can imagine what that is like with this flu or whatever it is.
  435.  
  436.  
  437.  
  438. I currently have no mobility in my head or neck.
  439.  
  440. Body aches everywhere.
  441.  
  442. Severe fatigue (constant)
  443.  
  444. Dizziness.
  445.  
  446. Loss of appetite.
  447.  
  448. Freezing cold (constant).
  449.  
  450. Insomnia.
  451.  
  452. Constant headache.
  453.  
  454. Severe tinnitus.
  455.  
  456. Nausea.
  457.  
  458. I have had the above for months, and they are getting progressively worse.
  459.  
  460. I do have benign paroxysmal positional vertigo which was diagnosed by Heuser Hearing Institute here in Louisville, however I am unable to continue treatment with it as I simply do not have the co-pay.
  461.  
  462. I do have an adrenal adenoma.
  463.  
  464. I currently have either the flu or bronchitis which I cannot get treatment for because I do not have the co-pay.
  465.  
  466. I had a ruptured brain aneurysm back in 1998 (major subarachnoid hemmorage) which has left me with a few problems, as well as a periventricular shunt.
  467.  
  468. I have a vertebrobasilar insufficiency bought caused by the aneurysm, diagnosed by Dr. Walter Olson, a neurology specialist in movement disorders.
  469.  
  470.  
  471.  
  472. Just to mention a few. Dr. Wood now suspects fibromyalgia. I do not have the copay to see a specialist.
  473.  
  474.  
  475.  
  476. Please, if there is anything you can do to complete my claim I would greatly appreciate it.
  477.  
  478.  
  479.  
  480. Thank you,
  481.  
  482. Vicky Vinch
  483.  
  484.  
  485.  
  486.  
  487.  
  488. CONFIDENTIALITY NOTICE: This electronic message transmission is intended only for the person or the entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this transmission, but are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this information is strictly prohibited. If you have received this e-mail in error, please contact the sender of the e-mail and destroy the original message and all copies.
  489.  
  490. Reply Reply All Forward
  491. Hillerich, Laura Laura.Hillerich@shps.comHide
  492. To VLVinch VLVinch@aol.com
  493. Slideshow
  494. Vicky, when are you available to talk today?
  495.  
  496.  
  497.  
  498. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  499. Sent: Monday, December 19, 2011 12:24 PM
  500. To: Hillerich, Laura; Gibson, JC
  501. Subject: Re: FW: MD's Notes
  502.  
  503.  
  504.  
  505. Laura -
  506.  
  507.  
  508.  
  509. I had previously requested the documents from my bank, Chase (which you indicated you received and returned), to be completed and returned to me so I would not default on my mortgage. Amanda from your office called me shortly after you did and said she emailed it to me. i told her I had not received it. She said I would be getting it shortly. That was maybe what - a week ago? To date I have not received it and Chase says they have not, either.
  510.  
  511.  
  512.  
  513. Again, as I originally requested, please complete the information for my Chase Payment Assurance and return it TO ME so I can ensure Chase receives it. You can send it as an attachment to an email to me at this address. But I HAVE to have this in my hand ASAP otherwise I may be in danger of losing my home. Since I have no phone or electric at my home I need this ASAP so I can drive it over to chase. By ASAP I mean before Wednesday, December 21, 2011.
  514.  
  515.  
  516.  
  517.  
  518.  
  519. Thank you, as always, for everything you do.
  520.  
  521. Merry Christmas,
  522.  
  523. Vicky
  524.  
  525.  
  526.  
  527.  
  528.  
  529. In a message dated 11/21/2011 5:11:30 P.M. Eastern Standard Time, VLVinch@aol.com writes:
  530.  
  531. Will be home all day, but will be out for 1/2 hour at 11AM.
  532.  
  533.  
  534.  
  535. In a message dated 11/21/2011 4:27:15 P.M. Eastern Standard Time, Laura.Hillerich@shps.com writes:
  536.  
  537. Vicky, what does Wednesday look like for your schedule?
  538.  
  539.  
  540.  
  541. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  542. Sent: Monday, November 21, 2011 1:31 PM
  543. To: Hillerich, Laura
  544. Subject: Re: FW: MD's Notes
  545.  
  546.  
  547.  
  548. Laura, thank you for touching bases. I do have an appointment tomorrow at 11:15AM and will be home until 10:30AM and after 1PM tomorrow (Tuesday).
  549.  
  550.  
  551.  
  552. If I do not hear from you, specifically, prior to then, you have a wonderful Thanksgiving.
  553.  
  554.  
  555.  
  556. Vicky
  557.  
  558.  
  559.  
  560.  
  561.  
  562. In a message dated 11/21/2011 1:25:40 P.M. Eastern Standard Time, Laura.Hillerich@shps.com writes:
  563.  
  564. Vicky, as previously communicated to you, JC would like to have some time that he might be able to talk to you regarding your questions. Unfortunately he has been pulled into a meeting that won’t allow a call today. Would you be available either tomorrow or Wednesday? If so please let me know which day and a time when you can be reached.
  565.  
  566.  
  567.  
  568. Thanks,
  569.  
  570.  
  571.  
  572. Laura
  573.  
  574.  
  575.  
  576. From: Gibson, JC
  577. Sent: Thursday, November 17, 2011 3:58 PM
  578. To: Gibson, JC; 'VLVinch@aol.com'
  579. Cc: Bauscher, Jon; Hennessy, Amanda; Lee, David
  580. Subject: RE: MD's Notes
  581.  
  582.  
  583.  
  584. Vicky, I wanted to check in with you. We are still working with our vendors to get your whole picture. Please allow our team till Monday afternoon to call you.
  585.  
  586.  
  587.  
  588. JC
  589.  
  590.  
  591.  
  592. From: Gibson, JC
  593. Sent: Monday, November 14, 2011 6:45 PM
  594. To: 'VLVinch@aol.com'
  595. Cc: Bauscher, Jon; Hennessy, Amanda; Lee, David
  596. Subject: RE: MD's Notes
  597.  
  598.  
  599.  
  600. Ms. Vinch, I wanted to let you know that I’m taking a personal interest in your case and we are working with Matrix, our vendor, to better understand the circumstances from which your complaint arises. Immediate resolution and response may be somewhat slowed as today I received your formal complaint as filed through the Kentucky Labor Cabinet. This filing requires a formal response to them as a part of the process.
  601.  
  602.  
  603.  
  604. Although I may be limited in how I can respond to you, I’m personally handling this investigation. Please give me 2 days to complete my investigation. Also, you can direct all future communication to me. Thanks,
  605.  
  606.  
  607.  
  608. JC Gibson
  609.  
  610. EVP, Human Resources
  611.  
  612. SHPS Inc
  613.  
  614. 502.326.4570
  615.  
  616. jc.gibson@shps.com
  617.  
  618.  
  619.  
  620.  
  621.  
  622.  
  623.  
  624. From: Mehrotra, Rishabh
  625. Sent: Monday, November 14, 2011 4:49 PM
  626. To: Gibson, JC
  627. Subject: FW: MD's Notes
  628.  
  629.  
  630.  
  631.  
  632.  
  633.  
  634.  
  635. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  636. Sent: Monday, November 14, 2011 4:45 PM
  637. To: Blanca.Parra@matrixcos.com
  638. Cc: Hillerich, Laura; Tatum, Mark; Susan.Long@ky.gov; Mehrotra, Rishabh
  639. Subject: Re: MD's Notes
  640.  
  641.  
  642.  
  643. Hi Blanca -
  644.  
  645. Firstly - if you could answer ALL of the questions in this email it would be greatly appreciated.
  646.  
  647.  
  648.  
  649. I did receive Matrix's letter just a short while ago via fax.
  650.  
  651.  
  652.  
  653. It states, " "Based on the medical records from Dr. Wood for the period of October 01, 2011 through November 23, 2011... "
  654.  
  655.  
  656.  
  657. How is this possible when today is only November 14th?
  658.  
  659.  
  660.  
  661. SECONDLY, please respond to my Question #2 (third request) - I need a coherent explanation as to how Matrix & SHPS can deny my disability as of October 7th when the FMLA was approved?
  662.  
  663.  
  664.  
  665. It appears that Matrix/SHPS is simply stalling paying the disability benefits. I hope that is not the case for all of our sakes. It also appears that no one there either completely read or understood the information that was provided to you.
  666.  
  667.  
  668.  
  669. What is your Supervisor's name, please?
  670.  
  671.  
  672.  
  673. Thank you,
  674.  
  675. Vicky
  676.  
  677.  
  678.  
  679.  
  680.  
  681.  
  682.  
  683. In a message dated 11/14/2011 3:21:36 P.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  684.  
  685. Vicky,
  686.  
  687. I had not sent you the denial letter as I was waiting on an approval from my supervisor so I am faxing over right now.
  688.  
  689. Thank you
  690.  
  691.  
  692.  
  693. Blanca Parra
  694. Integrated Claims Examiner
  695. Matrix Absence Management, Inc.
  696. Phone: 602.866.2333 ext. 56022
  697.  
  698. Fax: 602.866.9707
  699. blanca.parra@matrixcos.com
  700. www.matrixcos.com
  701. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  702.  
  703.  
  704.  
  705. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  706. Sent: Monday, November 14, 2011 11:37 AM
  707. To: Blanca Parra
  708. Cc: laura.hillerich@shps.com; mark.tatum@shps.com; Susan.Long@ky.gov; rishabh.mehrotra@shps.com
  709. Subject: Re: MD's Notes
  710.  
  711.  
  712.  
  713. Good Morning, Blanca -
  714.  
  715.  
  716.  
  717. Per your email dated November 8, 2011, you'd indicated you would be faxing me the denial information of my Short Term Disability claim as well as outlining the appeals process. To date I have received nothing.
  718.  
  719.  
  720.  
  721. I'd also asked how Matrix/SHPS can deny the disability claim when the FMLA was approved - can someone please explain this to me?
  722.  
  723.  
  724.  
  725. To reiterate, I need from Matrix and/or SHPS:
  726.  
  727.  
  728.  
  729. 1. What is the appeals process.
  730.  
  731. 2. A coherent explanation as to how Matrix & SHPS can deny my disability as of October 7th when the FMLA was approved.
  732.  
  733.  
  734.  
  735. Thanking you in advance. I hope your week goes well,
  736.  
  737.  
  738.  
  739. Best Regards,
  740.  
  741. Vicky Vinch
  742.  
  743.  
  744.  
  745.  
  746.  
  747.  
  748.  
  749. In a message dated 11/9/2011 6:52:32 P.M. Eastern Standard Time, VLVinch@aol.com writes:
  750.  
  751. Blanca, I appreciate everything you've done. According to this letter I have from SHPS dated 10/29/11 (the nation's leading provider of benefits administration solutions), my COBRA coverage will cost $468.62 per month. According to Anthem (below) my coverage had expired on October 13th (a week before I was notified by SHPS via telephone that my employment had been terminated although Matrix indicated my FMLA was approved). The $272.54 you've so graciously agreed to send will not even cover my COBRA. I am now out of my hypertension medications as well (yes, I also have malignant hypertension). So basically I am cooked. But thanks for trying. You've been wonderful.
  752.  
  753.  
  754.  
  755.  
  756.  
  757. You have a good evening & stay well,
  758.  
  759. Vicky
  760.  
  761.  
  762.  
  763.  
  764.  
  765.  
  766.  
  767. In a message dated 11/9/2011 5:51:34 P.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  768.  
  769. Vicky,
  770.  
  771. I do apologize it was mailed 11/08/11.
  772.  
  773. Thank you
  774.  
  775.  
  776.  
  777. Blanca Parra
  778. Integrated Claims Examiner
  779. Matrix Absence Management, Inc.
  780. Phone: 602.866.2333 ext. 56022
  781.  
  782. Fax: 602.866.9707
  783. blanca.parra@matrixcos.com
  784. www.matrixcos.com
  785. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  786.  
  787.  
  788.  
  789. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  790. Sent: Wednesday, November 09, 2011 3:25 PM
  791. To: Blanca Parra
  792. Cc: laura.hillerich@shps.com; mark.tatum@shps.com; Susan.Long@ky.gov
  793. Subject: Re: MD's Notes
  794.  
  795.  
  796.  
  797. It only takes a week for mail to get here from Matrix. If it was mailed October 8th, 2011, I suggest you re-check my address, please, because I have not received it.
  798.  
  799.  
  800.  
  801. In a message dated 11/9/2011 5:20:24 P.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  802.  
  803. Hello Vicky,
  804.  
  805. I have submitted the denial to my supervisor for approval once approved I will fax it to the fax number that you provided. Also your benefits for the period of 09/3011 thru 10/07/11 in the amount of $272.54 were mailed to you on 10/08/11.
  806.  
  807. Thank you
  808.  
  809.  
  810.  
  811. Blanca Parra
  812. Integrated Claims Examiner
  813. Matrix Absence Management, Inc.
  814. Phone: 602.866.2333 ext. 56022
  815.  
  816. Fax: 602.866.9707
  817. blanca.parra@matrixcos.com
  818. www.matrixcos.com
  819. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  820.  
  821.  
  822.  
  823. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  824. Sent: Wednesday, November 09, 2011 2:06 PM
  825. To: Blanca Parra
  826. Cc: laura.hillerich@shps.com; mark.tatum@shps.com; Susan.Long@ky.gov
  827. Subject: Re: MD's Notes
  828.  
  829.  
  830.  
  831. I just received a phone call from my primary care physician's office (Blankenbaker Primary Care) - they say they received a fax requesting info about this disability request (I"m guessing it was from Matrix) and I attempted to make an appointment as they requested. However, when I informed them I did not have the copay plus the $20 he charges to fill out the forms they indicated they could not do it, although I have been a patient of this MD for over 5 years and owe them no money whatsoever.
  832.  
  833.  
  834.  
  835. FYI.
  836.  
  837.  
  838.  
  839. Thanks.
  840.  
  841.  
  842.  
  843.  
  844.  
  845.  
  846.  
  847. In a message dated 11/8/2011 1:10:50 P.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  848.  
  849. Vicky,
  850.  
  851. Yes I will fax it to the number you have provided.
  852.  
  853.  
  854.  
  855. Blanca Parra
  856. Integrated Claims Examiner
  857. Matrix Absence Management, Inc.
  858. Phone: 602.866.2333 ext. 56022
  859.  
  860. Fax: 602.866.9707
  861. blanca.parra@matrixcos.com
  862. www.matrixcos.com
  863. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  864.  
  865.  
  866.  
  867. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  868. Sent: Tuesday, November 08, 2011 11:08 AM
  869. To: Blanca Parra
  870. Cc: laura.hillerich@shps.com; mark.tatum@shps.com; Susan.Long@ky.gov
  871. Subject: Re: MD's Notes
  872.  
  873.  
  874.  
  875. Please fax it to me. Fax # is 708 290 5196.
  876.  
  877.  
  878.  
  879. How is Matrix able to justify the below decision when I also received FMLA approval?
  880.  
  881.  
  882.  
  883. Matrix has now gone against my physicians recommendations, and this will now make nearly five weeks with no income whatsoever. I have repeatedly asked you what it was you needed, and you have repeatedly indicated you received nothing from my physician when their documentation clearly shows it was sent & timestamped.
  884.  
  885.  
  886.  
  887. I find it even more curious that Matrix represents a "healthcare" company which boasts giving employees accurate and reliable service. Please ask "your supervisor" if she considers this accurate and reliable?
  888.  
  889.  
  890.  
  891. I now cannot even pay for my COBRA. I cannot pay for my prescription renewals. I have no homeowners insurance now or auto insurance.
  892.  
  893.  
  894.  
  895. You tell me I was "terminated" *while* on FMLA, on October 19, 2011, retroactive to October 12th, with NO indication from Matrix that my FMLA supposedly expired?
  896.  
  897.  
  898.  
  899. Vicky
  900.  
  901.  
  902.  
  903. In a message dated 11/8/2011 12:41:05 P.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  904.  
  905. Vicki,
  906.  
  907. I will provide the appeal process in your denial letter. Once my supervisor has review and approved the denial request I will create your denial letter and mail it out to you.
  908.  
  909. Thank you
  910.  
  911.  
  912.  
  913. Blanca Parra
  914. Integrated Claims Examiner
  915. Matrix Absence Management, Inc.
  916. Phone: 602.866.2333 ext. 56022
  917.  
  918. Fax: 602.866.9707
  919. blanca.parra@matrixcos.com
  920. www.matrixcos.com
  921. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  922.  
  923.  
  924.  
  925. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  926. Sent: Tuesday, November 08, 2011 10:10 AM
  927. To: Blanca Parra
  928. Cc: laura.hillerich@shps.com
  929. Subject: Re: MD's Notes
  930.  
  931.  
  932.  
  933. Blanca, what is the appeal process, please?
  934.  
  935.  
  936.  
  937. In a message dated 11/8/2011 11:51:54 A.M. Eastern Standard Time, Blanca.Parra@matrixcos.com writes:
  938.  
  939. Good morning Vicki,
  940.  
  941. The medical review has been completed and benefits will be approved from 09/23/11 thru 10/07/11. Benefits beyond 10/08/11 will be denied as self reports do not support, your labs were normal range. I will complete claim so that benefit go out for the period that has been approved.
  942.  
  943. Thank you
  944.  
  945.  
  946.  
  947. Blanca Parra
  948. Integrated Claims Examiner
  949. Matrix Absence Management, Inc.
  950. Phone: 602.866.2333 ext. 56022
  951.  
  952. Fax: 602.866.9707
  953. blanca.parra@matrixcos.com
  954. www.matrixcos.com
  955. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  956.  
  957.  
  958.  
  959. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  960. Sent: Tuesday, November 08, 2011 7:07 AM
  961. To: Blanca Parra
  962. Cc: laura.hillerich@shps.com
  963. Subject: Fwd: MD's Notes
  964.  
  965.  
  966.  
  967. Can anyone PLEASE tell me what you need???
  968.  
  969.  
  970.  
  971. From: Blanca.Parra@matrixcos.com
  972. To: VLVinch@aol.com
  973. Sent: 11/3/2011 3:10:14 P.M. Eastern Daylight Time
  974. Subj: RE: MD's Notes
  975.  
  976.  
  977.  
  978. Vicki,
  979.  
  980. I have received your medical notes I will submit for a medical review and will provide an update once completed.
  981.  
  982. Thank you
  983.  
  984.  
  985.  
  986. Blanca Parra
  987. Integrated Claims Examiner
  988. Matrix Absence Management, Inc.
  989. Phone: 602.866.2333 ext. 56022
  990.  
  991. Fax: 602.866.9707
  992. blanca.parra@matrixcos.com
  993. www.matrixcos.com
  994. "NOTICE: the information contained in this electronic mail transmission is intended by Matrix Absence Management, Inc., for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email or by telephone, so that the sender's address records can be corrected."
  995.  
  996.  
  997.  
  998. From: VLVinch@aol.com [mailto:VLVinch@aol.com]
  999. Sent: Thursday, November 03, 2011 11:43 AM
  1000. To: Blanca Parra
  1001. Subject: MD's Notes
  1002.  
  1003.  
  1004.  
  1005. Hello Blanca -
  1006.  
  1007.  
  1008.  
  1009. Attached please find the MD's notes from my endocrinologist, Dr. Donald D. Wood. When we'd previously spoken you'd indicated this is all that you'd needed in order to process my disability claim.
  1010.  
  1011.  
  1012.  
  1013. Anything you can do to expedite this claim would be greatly appreciated. I have not had any income in a month. I no longer have heat in my home - tomorrow night it is expected to reach the 30's. I was unable to make my mortgage payment last week. My homeowners & car insurance are both overdue. I have no paper products left in my house whatsoever so you can imagine what that is like with this flu or whatever it is.
  1014.  
  1015.  
  1016.  
  1017. I currently have no mobility in my head or neck.
  1018.  
  1019. Body aches everywhere.
  1020.  
  1021. Severe fatigue (constant)
  1022.  
  1023. Dizziness.
  1024.  
  1025. Loss of appetite.
  1026.  
  1027. Freezing cold (constant).
  1028.  
  1029. Insomnia.
  1030.  
  1031. Constant headache.
  1032.  
  1033. Severe tinnitus.
  1034.  
  1035. Nausea.
  1036.  
  1037. I have had the above for months, and they are getting progressively worse.
  1038.  
  1039. I do have benign paroxysmal positional vertigo which was diagnosed by Heuser Hearing Institute here in Louisville, however I am unable to continue treatment with it as I simply do not have the co-pay.
  1040.  
  1041. I do have an adrenal adenoma.
  1042.  
  1043. I currently have either the flu or bronchitis which I cannot get treatment for because I do not have the co-pay.
  1044.  
  1045. I had a ruptured brain aneurysm back in 1998 (major subarachnoid hemmorage) which has left me with a few problems, as well as a periventricular shunt.
  1046.  
  1047. I have a vertebrobasilar insufficiency bought caused by the aneurysm, diagnosed by Dr. Walter Olson, a neurology specialist in movement disorders.
  1048.  
  1049.  
  1050.  
  1051. Just to mention a few. Dr. Wood now suspects fibromyalgia. I do not have the copay to see a specialist.
  1052.  
  1053.  
  1054.  
  1055. Please, if there is anything you can do to complete my claim I would greatly appreciate it.
  1056.  
  1057.  
  1058.  
  1059. Thank you,
  1060.  
  1061. Vicky Vinch
  1062.  
  1063.  
  1064.  
  1065.  
  1066.  
  1067. CONFIDENTIALITY NOTICE: This electronic message transmission is intended only for the person or the entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this transmission, but are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this information is strictly prohibited. If you have received this e-mail in error, please contact the sender of the e-mail and destroy the original message and all copies.
  1068.  
  1069. CONFIDENTIALITY NOTICE: This electronic message transmission is intended only for the person or the entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this transmission, but are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this information is strictly prohibited. If you have received this e-mail in error, please contact the sender of the e-mail and destroy the original message and all copies.
  1070.  
  1071. CONFIDENTIALITY NOTICE: This electronic message transmission is intended only for the person or the entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this transmission, but are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this information is strictly prohibited. If you have received this e-mail in error, please contact the sender of the e-mail and destroy the original message and all copies.
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