Most of you know that for the last seven years, I've had constant battles with my insurance company (Anthem Blue Cross) and my HMO (Regal Medical Group). I've won some battles but the war is far from over. Two days ago I filed a grievance with the Calif Dept of Managed Health Care. I am still fighting for reimbursement of medical expenses from 2011, over $1300. I filed a grievance in Sept 2011 to get feeding tube surgery. I asked for an expedited grievance since my already low weight had gone into free fall: from 120-lbs down to 94-lbs (I'm 5' 7" tall). The HMO waited 29 days to approve treatment for dysphagia (inability to swallow) and extreme weight loss (feeding tube surgery), side effects of treatment for throat cancer in 2006. Then, they reneged on payment. My primary care physician initially sent me to Regal's gastroenterologist at Caduceus Specialty Physicians (which Regal owns). She couldn't do it. She sent me to Regal's general surgeon. He declined to treat me, twice, saying I needed a gastroenterologist surgeon at UCI [I had had emergency abdominal surgery Aug 21, 2011 for small bowel obstruction; 3-ft was removed because treatment had been delayed and gangrene had set in]. I filed a grievance (denied) and then an appeal (also denied), even though I included their letter dated Oct 18, 2011, approving the treatment (Case #0222771372). When I mentioned the on-going problem with my primary care physician this year, he said "They can't do that….!"

This is bad enough, but what they did to my husband should be criminal. Our primary care physician had been treating my husband for years for chronic breathing problems. Finally, in 2010, he sent him to a pulmonologist at Caduceus Specialty Physicians. Most of their "specialists" are actually "generalists," with minimum qualifications in their field. But Regal owns the facility, so they make more money by sending patients there for treatment. On Nov 5, 2010, my husband saw Dr Bertrand De Silva. He ordered a lung cancer biopsy which was done Dec 1, 2010 at Placentia-Linda Hospital, and a spiral CT scan done at Imperial Imaging (Yorba Linda). When my husband returned to the office, Dr De Silva gave him the diagnosis: Valley Fever and COPD. He specifically said, no, my husband didn't have lung cancer. On Oct 1, 2012, I took my husband to the hospital emergency room; he was admitted for further testing (MRI and spiral CT scan). He received the diagnosis Oct 3, 2012: stage 4 lung cancer and metastatic brain cancer. He died Oct 27, 2012. The only explanation for Dr De Silva's diagnosis and Regal Medical Group's failure to provide any further follow-up care, other than by our primary care physician: greed and malpractice. I had begged Gary to get a second opinion, but knowing what I went through trying to get treatment, he declined and decided to go along with the care provided by Regal. He paid with his life.

Thanks for your help and support. It means the world to me.

Lynn