TO: 1. Medicare 2. my insurance company
I wrote to…read moreMedicare & my ins company to APPEAL any and all charges from Hugo Caballero, his lab, and QUEST Diagnostics lab
HELLO: this is my 1st UPDATE set of notes, my Appeal
Please consider this to be an official APPEAL to 1 & 2 listed above. This APPEAL is
against incomplete & fraudulent medical healthcare lab service that I experienced Sep14-16, 2022, by Dr Kelsey James, NP, as follows:
Hugo A Caballero, MD Family Healthcare Group;
ATTN: Dr. Kelsey James,
1920 Kirby Pkwy #202.
Memphis, TN 38138-3610
(901) 751-9997
COUNT 1 (Doctor's in-house lab;
appears Quest did some lab work-all mixed):
Encl 1, Glucose,"73", page 1; page 5 "67", & "negative"; impossible; 3 Results???
So, lab says Glucose is 67 & 73 (normal 65-99); notice these #'s are moved
closer to 65; my Quest Glucose history records are as follows: I challenge
Caballero's inhouse lab to PROVE values of 67 & 73 are accurate, Glucose.
I have hard
copies of Quest's following lab results & may include one as material evidence, Encl 2.
Glucose 12/10/2014 113 H 99-125 pre-diabetes
Glucose 011/3/2015 108 H 99-125 pre-diabetes
Glucose 11/15/2016 123 H 99-125 pre-diabetes
Glucose 03/04/2016 105 H 99-125 pre-diabetic
Glucose 08/18/2017 106 H 99-125 pre diabetic Encl 2
GLUCOSE healthful zone 65-99
Glucoselabs of 67 & 73 are in normal range; 67 & 73 (two?? ); can't be two #s
prediabetic 100-125;
126 or higher Diabetic
I recently have ordered 2 mail-order HgbA1c tests; 1st was 6.2 JULY & the results are
pre-diabetic; pls call me. The HbA1c value of 6.2 was found, and that is
within a pre-diabetic zone of 5.7 and 6.4; PRE-DIABETIC, all consistent with
Quest lab results that I typed in above for Glucose, 2014-2017.
UPDATE dtd 0928/2022: Today I rec'd my 2nd HbA1c result (in JUL it was 6.2 & this one
Encl 1 shows it lowered to 6.1 (still Pre-Diabetec). On Encl 2 (Page 5 of lab tests on
original APPEAL, I wish to make the following observations: range provided 3.9-6.5
is full of lies (6.5 & higher is Diabetic; norm less than 5.7;
pre-diabetic is 5.7-6.4.
They inserted fraudulent HbA1c value of 5.9 for 09142022; however the 5.9 is also
pre-diabetic, but I was denied a medical Dx of pre-Diabetes (not in writing, nor
verbally). Also on Encl 1 herewith, for GLUCOSE the value of "67" is a FRAUD because
I cannot be Pre-Diabetic with HbA1c AND have GLUCOSE lab Result "normal";
BOTH should be Pre-Diabetic. For some reason these folks are wrong, wrong, wrong !!!
And they must not be paid for incomplete and fradulent services; in-house lab & Quest
Diagnostics too, please. If they are doing duplicate lab work appears to be duplicate
plus some is obviously misleading and fraudulent, then neither should be paid, I again
APPEAL to you to NOT pay this Doctor, nor for the lab work. Please have your
investigator's to review what I have submitted to you. I doubt I made any mistakes
but I'm not perfect. I guarantee most of it is correct and very rational. I Appeal
that no payments of any type should be made by Medicare, nor my Insurance co, all based upon all this conflicting medical lab evidence that I have presented
to you today Supplement 1, plus the original Appeal. I kindly thank you for your
full cooperation.
COUNT 2 (BLOOD PRESSURE; failure to diagnose and treat STAGE 2 HYPERTENSION).
"In the USA, over half of the people aged 60 and over have high blood
pressure, or hypertension, and maintaining one's blood pressure at healthy
levels can be crucial. The American College of Cardiology & American Heart
Association (ACC/AHA) guidelines recommend a systolic blood pressure of NO
HIGHER than 130 milligrams of mercury (mmHg) Trusted Source for those over
65." My blood pressure was 144/76. Kelsey James (KJ), said my blood
pressure was high but it's not bothersome to her!
According to Mayo Clinic, blood pressure is grouped according to how
high it is. This is called staging. Staging helps guide treatment.
Stage 1 hypertension. The top number is between 130 and 139 mm Hg or
the bottom # is between 80 and 89 mm Hg.
= STAGE 2 HYPERTENSION. The top # is 140 mm Hg or higher or the bottom
# is 90 mm Hg or higher.
As you can obviously see I am STAGE 2 HYPERTENSION; KJ denied me proper Dx
(obvious health care omission); FUTHERMORE, KJ failed to treat me
for STAGE 2 HYPERTENSION (gross health care negligence).
Glucose values (?) of 67 & 73 (normal) is INconsistent w/Hx & A1c of pre-diabetic;
I APPEAL any/all/by lab work claim submitted for in-house & Quest Diagnostics or
any claim submitted, Quest Diagnostics for lab work service between Sep 14 &
September 16, 2022.
I APPEAL any & ALL claims submitted,Hugo A Caballero Fam
Healthcare Grp. provided 3 #'s Glucose;"67", "73" & "negative"; impossible! Good Day;Beware