Proof We are Treated as Second Class TRICARE Beneficiaries Using DHA’s Own Data

Many times we refer to Philippine TRICARE beneficiaries as being treated as second class beneficiaries by the Defense Health Activity (DHA) and International SOS (ISOS).

There are many reasons for this classification including multiple Philippine unique policies that are designed to cause beneficiaries to be denied access to care and denied payment for legitimate care from legitimate providers and all in the name of protecting the taxpayer from massive fraud; if one cares to believe the DHA hype. In addition ISOS tends to ignore beneficiary inquires claiming secrecy or just ignore you after saying they will get back to you. Continue reading

Posted in Closed Network, CMAC Table, Emergency Care Access, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines | 4 Comments

Satisfaction Survey Phase I of the TRICARE Demonstration

I’ve been in contact with DHA who has indicated the contractor has not had a lot of success in contacting many of those eligible to participate. In an attempt to reach these people they agreed that I could put out the following information.

If you want to participate in the survey and qualify you should contact the following individual by email or phone. Please do not contact this individual with individual problems with claims etc.

Dr. Kimberley Marshall
Phone: 703-681-3636
Email: Kimberley.Marshall@tma.osd.mil

All retired military, spouses and survivors are eligible to take the survey if they meet the qualification below and should follow the guidance offered below.

A beneficiary qualifies for the survey only if he/she has a TRICARE claim in the system for care received in the Phase I designated demonstration areas January 1, 2013 to December 31, 2013.

Individuals should be reminded that SSNs should not be provided via e-mail.  The beneficiaries should provide their name (as it is in DEERS), e-mail address, and phone number.  If a beneficiary has one e-mail address shared by the entire family, authorization must come from the other family member(s) that he or she authorizes the survey contractors, Deloitte/Zogby, to also send a survey to that e-mail address for him/her.  If a telephone survey is conducted and the beneficiary does not understand English, he or she must authorize Deloitte/Zogby to speak with another member in the household if he/she will be translating for the beneficiary.

Jim Houtsma
USMRoP

Posted in Closed Network, Tricare Management Activity (TMA) | Tagged | 3 Comments

Update: Proof We are Treated as Second Class TRICARE Beneficiaries

We will not repeat what we previously discussed in the original post, Proof We are Treated as Second Class TRICARE Beneficiaries Using DHA’s Own Data from 29 December 2013. If you have not read it, click on the title and you will be able to read it at your leisure.

We are only updating the information showing how much the Defense Health Agency (DHA) pays for care in the Philippines compared to the rest of the world and it is significantly worse than before when it showed they were spending 13% of what was expected based on 2010 TRICARE data.

We tried to give DHA every benefit of the doubt when we made the calculations. The indisputable facts and assumptions are below. Continue reading

Posted in Certified Provider List, Closed Network, CMAC Table, Demonstration, Emergency Care Access, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines, Wisconsin Physician Services (WPS) | Tagged | 3 Comments

Army Times Offers Assistance to a Philippine TRICARE Beneficiary

We posted this subject with tongue in cheek which will become clear once you read this article and the actual Army Times TRICARE Help column. You can post a comment on their link or send an email as I did.

Before we start we would like to get in contact with the individual that wrote in for help; he really does need help. If anyone that reads this Blog knows the individual please ask him to contact us so we can assist in getting his claims paid. Continue reading

Posted in Certified Provider List, Closed Network, CMAC Table, Defense Health Agency (DHA), Demonstration, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines, Wisconsin Physician Services (WPS) | Tagged , , | 4 Comments

Tricare Philippines Newsletter, Access to Care, Jiving Congress & Hiding Under the Skirts of Contractors

In our latest Newsletter we show how little money is spent on TRICARE in the Philippines compared to all other areas. We point out serious misstatements and avoiding the questions in Gen Bobb’s statement to Congress on issues in the Philippines and finally we point out a new twist to TRICARE contracting out.

Access to Care, Jiving Congress & Hiding Under the Skirts of Contractors.

 

Posted in Tricare Overseas Program Philippines | Leave a comment

1 September 14 List of Certified Providers Removed in Secret, Limited Demo Access to Care

International SOS (ISOS) no longer posts lists of Certified or Approved providers as they continue to reduce their costs at the detriment of beneficiaries in the Philippines. We reviewed the total listing of providers and compared them to the previous total listing to determine any suspicious removal activity and to see the bigger picture of trends such as the continued loss of access to care in Angeles and which is now hidden from the average beneficiary. Continue reading

Posted in Certified Provider List, Closed Network, Defense Health Agency (DHA), Demonstration, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines | Tagged | 6 Comments

TRICARE Appeal Process in Action and Lessons Learned Along the Way

Anyone that has tried to use the appeal or complaint processes through the TRICARE system knows they are designed to make the process as difficult and drawn out as possible.

Filing Complaints

Have a complaint against International SOS (ISOS)? Are you tired of their wrong answers on the phone or telling you they don’t know the answer but will call you back and never do? Are you tired of sending emails to this contractor only to be ignored? Go to Contact Us in ISOS’s very own web page; you know the one called “www.tricare-overseas.com”. Go to any country and this is what you will find. Continue reading

Posted in Closed Network, Defense Health Agency (DHA), Demonstration, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines, Wisconsin Physician Services (WPS) | Tagged , | 2 Comments

1 August 14 List of Certified Providers Removed in Secret, Massive Loss of Access to Care in Angeles Continues

International SOS (ISOS) no longer posts lists of Certified or Approved providers as they continue to reduce their costs at the detriment of beneficiaries in the Philippines. We reviewed the total listing of providers and compared them to the previous total listing to determine any suspicious removal activity and to see the bigger picture of trends such as the continued loss of access to care in Angeles and which is now hidden from the average beneficiary. Continue reading

Posted in Certified Provider List, Closed Network, Defense Health Agency (DHA), Demonstration, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines | Tagged | 3 Comments

New Try at a Demonstration Survey

Back in March 2014, 4.5 months ago, we received what the Defense Health Agency (DHA) likes to call a “TRICARE email update” entitled Philippine Demonstration Project: How Are We Doing? Our inquiries, at the time, about the survey resulted in us being told it would start in a few weeks. As the weeks passed and nobody was contacted we inquired again. This time we were told that DHA forgot about a government requirement concerning contractors and access to medical information. We continued to follow-up on the status. Finally about three weeks ago we were told the survey would start within a few days. Continue reading

Posted in Closed Network, Defense Health Agency (DHA), Demonstration, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines | Tagged | 9 Comments