Blue Shield of California says a “routing” problem with its internal phone system, and not the merits of a San Francisco firefighter’s insurance appeal, is to blame for why the patient’s oncologist was unable to submit his appeal over the phone after calling the number listed on Blue Shield ’s denial letter and spending hours on the call.  The insurance company says the number was intended for patients, not doctors, and that it has since corrected the issue. At the same time, Blue Shield declined to answer additional insurance-related questions about the firefighter, Ken Jones, who died of lung cancer last month.  Blue Shield said a federal privacy authorization Jones signed before his death to give NBC Bay Area access to his insurance record is no longer valid in the wake of his death.  NBC Bay Area, however, contacted the federal agency responsible for enforcing those regulations and learned the restrictions referenced by Blue Shield do not appear to prohibit the company from answering such questions, saying health record authorizations do not automatically expire when a patient dies. Blue Shield denied coverage for part of Jones’ cancer treatment late last year. While the insurance company approved chemotherapy to target Jones’ cancer, it denied the immunotherapy Jones’ oncologist prescribed to bolster Jones’ immune system to also attack the disease. Ken Jones, a veteran San Francisco firefighter, passed away in May after living with Stage 4 lung cancer. As NBC Bay Area first reported in February, Jones’ oncologist Dr. Matthew Gubens attempted to appeal the initial denial by calling the very number listed on Blue Shield’s denial letter, but ended up spending hours on the phone without ever reaching the appropriate person. “I reached people who apologized, but they weren’t the right place to send the appeal to, and often referred me back to the first person I talked to,” Gubens previously told NBC Bay Area.  “That number goes through a phone tree that eventually hangs up on me.” Gubens ultimately submitted his appeal to Blue Shield in writing, but the insurer denied it. Dr. Matthew Gubens, who served as Ken Jones’ oncologist, heads the Thoracic Medical Oncology Clinic at UC San Francisco. Beginning more than four months ago, NBC Bay Area asked Blue Shield why Gubens was unable to successfully lodge an appeal over the phone after calling the number listed on the company’s denial letter.  Blue Shield did not provide a response, nor did it make anyone available for an interview. Earlier this month, however, Blue Shield Senior Vice President of Commercial Markets Tim Lieb agreed to an interview with NBC Bay Area.  Lieb was meeting with firefighter advocates at San Francisco City Hall to discuss possible reforms the insurance company could make following public outcry over Blue Shield’s partial denial of Jones’ cancer treatment.  NBC Bay Area interviewed Lieb after the closed-door meeting, but Lieb said he wasn’t able to address Jones’ particular case, including why Jones’ oncologist was unsuccessful in reaching the appropriate Blue Shield representative after phoning the company’s appeals hotline. “We cannot talk about any of the member-specific issues — that’s not something we’re able to do,” he said.  “There’s questions, but we can’t respond to them.” Tim Lieb is Blue Shield Senior Vice President of Commercial Markets. Following the interview, NBC Bay Area sought clarification in light of the fact Jones had previously signed an authorization form permitting Blue Shield to discuss his insurance records with NBC Bay Area. The form is intended to satisfy federal medical privacy requirements under the Health Insurance Portability and Accountability Act, commonly known as HIPAA, and permitted Blue Shield to discuss Jones’ insurance records with NBC Bay Area. In fact, the authorization form Jones signed allowed the insurance company to discuss “any and all information Blue Shield maintains.” A Blue Shield spokesperson, however, said the authorization was no longer valid in light of Jones’ death. “According to Health and Human Services, when a patient passes away, any signed HIPAA authorization form giving permission to discuss that patient’s [protected health information] becomes legally null/void,” the spokesperson wrote in an email.  “In accordance with state and federal privacy laws, we are unable to discuss Mr. Jones with you.” NBC Bay Area then contacted HHS, which said authorizations do not automatically become invalid when a patient dies, contradicting Blue Shield’s assertion that Jones’ authorization became “legally null/void” upon his death. “If an authorization is in effect at the time of the individual’s death … the authorization remains valid,” an HHS spokesperson said.  The authorization form Jones filled out notes an expiration date “one year from the date of signature.”  The form is dated Jan. 28, 2026.  Thus, according to HHS’s explanation, the authorization should remain in effect for approximately seven more months and was valid at the time Blue Shield told NBC Bay Area it could not discuss Jones’s case. NBC Bay Area requested additional clarification from Blue Shield regarding the apparent discrepancy between the company’s interpretation of the policy and HHS’s explanation of it. Blue Shield of California, which insures nearly 6 million people — roughly 15% of the state’s population — did not address that specific issue.  The company did, however, provide new information about Jones’ case after previously declining to discuss it.  For the first time, Blue Shield explained why Jones’ oncologist spent hours attempting to reach the appropriate department after calling the number listed on the denial letter. The number Jones’ doctor phoned, which was listed on Blue Shield’s denial letter, is a “member services line” intended for patients – not doctors, according to a Blue Shield spokesperson.  A “routing” problem, according to Blue Shield, led to the physician being repeatedly transferred from one incorrect person to another. Blue Shield said it has since updated its procedures and provided its staff with new training to address the issue. “To help improve the experience, we have enhanced our processes and provided additional training to support more efficient routing to the appropriate teams,” the Blue Shield spokesperson said. According to Jones’ oncologist, the insurance company’s initial denial and the appeals process that followed led to a delay in critical care. “Any of our cancer treatments are harder to give and less effective the weaker a patient is when we’re seeing them,” Gubens said. “Even in a disease that will lead to someone’s death, if I could get more years of quality time, that’s something patients value and their families do as well.” Watch our entire investigative series Part 1: Veteran San Francisco firefighter denied cancer treatment Part 2: Beloved firefighter tearfully reacts to insurance denial of Stage 4 cancer drugs Part 3: Firefighter couple ‘outraged’ after oversight board sides with Blue Shield Part 4: Firefighter dumps Blue Shield in hopes of getting previously denied cancer care Part 5: CA lawmaker summons Blue Shield to discuss firefighter’s cancer treatment denial Part 6: Blue Shield in hot seat after San Francisco firefighter’s cancer care denial Part 7: SF Supervisors question Blue Shield over firefighter’s stage 4 cancer treatment denial Part 8: Firefighter dies of cancer after protracted battle with insurance company  Part 9: Blue Shield weighs insurance reforms after firefighter Ken Jones dies of cancer Contact The Investigative Unit submit tips | 1-888-996-TIPS | e-mail Bigad Follow @BigadShaban on social media Bigad Shaban ...read more read less