Ms. Carol Ryan
Professional Home Health
60 Rancho Road, Suite #27
Thousand Oaks, CA 91362

Dear Ms. Ryan:

It would be impossible for me to police the medical field industry to make sure patients are receiving their appropriate benefits.
As you may or may not know, I have filed against CareAmerica for abandonment practice.  It is therefor quite natural for them to deny claimed benefits, forcing litigation between patient and provider.  It is however not the patient's responsibility to intervene in the resolution of these disputes, as your telephone calls and letters seem to indicate.  Specifically, it is not my responsibility, as patient's conservator, to step in and recover your missing records, rectify accounting errors nor involve the patient in binding arbitration as alternative to her original contractual agreement per her health plan's initiation more than three years ago.   Contrary to what you say, the patient has never "switched" carriers, but rather, the plan has moved from carrier to carrier, each carrier utilizing the plan's primary provider, Prairie Group, who in turn, I can only presume, contacted and contracted you as the specialized provider of the patient's nutrition, where in turn, you went along willingly as long as you realized contractual assets.
I understand your dismay, since I know for a fact, Prairie Group never possessed Constance's medical records, however, I can assure you that the patient is alive and that Fiber Source is an essential component to her recovery.  As you know, the only way these conditions can be altered is by the primary care physician's orders and not by financial limitations imposed by an accounting office, such as yours.
You have repeatedly made the vain attempt to suggest that this patient is no longer covered, simply because the original carriers have sold their interest in the plan to CareAmerica or because the patient's original employer failed in business.  The fact is, per the patient's original contract, as explained in her Summary of Benefits, treatment for this specific injury is unlimited and unbounded without further stipulation or conditions.
As the plan's legally assigned provider, Professional Home Health Services cannot ignore their contractual liabilities in their willingness to engage their business in the health care field, where the well-being of patients actually supersedes profit incentives, as has been ruled by the California State Department of Corporations (DOC vs. MedPartners).  It is not the patient's responsibility nor obligation to providers to explain, know or otherwise divulge where they stand in their relationship to the plan's administrators, nor is it necessarily correct, accurate nor prudent for providers to assume that the patient's position in the matter is wrong, simply because the plan's most recent carrier denies payment for benefits or expresses to them benefit denial.
In light of this response to you, I will expect your service to this patient to continue without any more confusion and I expect an immediate response by you in writing.

Sincerely,

Joel E. Webb
910-B 20th Street, Santa Monica, CA 90403

copies to:    Raouf Khalil, CEO, Professional Home Health Services
                   Julie Uyemura, Director of Pharmacy, Professional Home Health Services
                   Claims Department, CareAmerica Health Plans
  Mr. Eugene Froelich, Dept. of Corporations