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

Tricare Philippines Newsletter 15003, Some Observations from Reviewing and Investigating Errors and Other Anomalies on the Approved and Certified Lists

In our latest Newsletter we show you that the Not Used In > 2 Years list of Certified Providers can no longer be considered viable and many of the certified providers on the list in at least some areas are also questionable as they may well be providers that should been moved to the Not Used in > 2 Years list. If beneficiaries use them they may find their claims delayed or worse denied.

We also show just how bad the management of the Demo is when it comes to access to care, how DHA doesn’t have a clue where we live and how DHA and ISOS break their own rules when it is convenient for them. But if you do it, expect to be punished by non-payment of claims.

See Some Observations from Reviewing and Investigating Errors and Other Anomalies on the Approved and Certified Lists

Posted in Certified Provider List, Closed Network, Defense Health Agency (DHA), Demonstration, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines, Wisconsin Physician Services (WPS) | Leave a comment

DHA and ISOS Continue to Put Out False Information About the TRICARE Overseas Standard Benefit in the Philippines

Today we received an email from TRICARE Subject: TRICARE Overseas Program Standard Health Matters Newsletter: 2015—Issue 1. In the email there was a link to the subject newsletter.

We read through the newsletter and were amazed to see the following statements on page 7 under what they call the FAQ corner. These are two of the questions and answers and are so blatantly wrong that we felt we have an obligation to make sure no beneficiaries are taken in. Continue reading

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

1 May 15 List of Certified Providers Removed in Secret & ISOS Fraud

We are sorry we missed posting the 1 April 15 list; a number of personal issues that took priority. However we did gather the information and the databases we maintain were updated.

As of 1 April 2015 there were another twelve (12) providers that went missing under mysterious circumstances and were not added to the Not Seen in > 2 years list.

As of 1 May 2015 yet another thirteen (13) providers also went missing under mysterious circumstances and were also not added to the Not Seen in > 2 years list. One provider that was an approved provider in Iloilo was removed and replaced using their real name as it seems they screwed up her name previously. But that is not news as it routinely happens almost monthly. Continue reading

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

ISOS Still Declares Cebu Doctor’s Hospital is Not a Real or Legitimate Hospital But the VA Disagrees

In March 2013 International SOS (ISOS) quietly and secretly removed Cebu Doctor’s University Hospital from the Certified Provider List. Multiple attempts over most of a year proved futile in obtaining anything more than double talk and claims of a need for secrecy when dealing with Philippine providers.

One of their infamous claims has been the secrecy is required because their clerks conduct Quality Assurance Checks. Of course none of their clerks are trained to conduct such checks and the TRICARE Operations Manual clearly states that the TRICARE Overseas Contractor (TOP) is not required to conduct any quality assurance checks on overseas providers. In addition to do a proper quality assurance check on a hospital would take hundreds of man hours and the full cooperation of the hospital and staff physicians by releasing all their records. But as is typical of this contractor they prefer to lie and steadfastly proclaim photographing buildings and obtaining copies of licenses and tax documents constitutes quality assurance checks. This makes them the laughing stock of all those that really do conduct quality assurance checks but then what is new. Continue reading

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

Tricare Philippines Newsletter 15002, TRICARE Knowingly and Blindly Pays for Fraudulent Care, Phase I Demonstration Survey Results are Secret

In our latest Newsletter we show how the Defense Health Agency (DHA) knew for years there were viable and industry wide used processes to root out fraud. And there was likely fraud at their door step that they also chose to ignore.

We also pass on the DHA decision to hide the results of the Phase I Demo survey from those most affected.

See TRICARE Philippines Newsletter 15002

Posted in Closed Network, Defense Health Agency (DHA), Demonstration, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines | 1 Comment

Confirmed: The Results of the Demo Survey are Secret/Classified

Or How to Hide Your Lies When You Don’t Want Beneficiaries to Know You Lied About Them

After weeks of waiting we were finally told the Defense Health Agency (DHA) has no intention of allowing mere beneficiaries to see either the results or analysis of the [Fake] Phase I Philippine Demonstration Project Survey.

As we found earlier DHA was not really interested in the opinions of those that were forced to use this debacle, The Demonstration Survey; How it Really Worked. Since they all but eliminated 100% of those that actually “lived in or received care in Manila, Angeles City, Pampanga, Olongapo City or Zambales any time during 2013″ in spite of what they officially published the only conclusion is the results and accompanying analysis is totally manufactured. The primary purpose for this fake survey will be to convince Congress and the DODIG that the vast majority of us used and loved the Demonstration. And we loved the massively higher prices negotiated by International SOS (ISOS), lack of claims filing for deductibles, secret provider agreements that increased our costs exponentially and the complete lack of quality checks on the small number of providers that beneficiaries were forced to use.

Like the lies put out by Lt. Gen Robb, Director of DHA, to Congress on the promised local office and employee it just seems to become easier and easier for these bureaucrats to tell bigger and bigger lies.

If you want to find out the real story behind DHA’s and ISOS’s focused attack on TRICARE beneficiaries in the Philippines instead of their spin and propaganda, read TRICARE: Betrayal in the Philippines, Is This the Future of TRICARE Overseas? It is available at the link and most online book sales outlets such as iBooks, Barnes & Noble, Amazon and others.

Never forget the Defense Health Agency and International SOS always have your back when it comes to high quality and easy access to care; just ask them!

Posted in Closed Network, Defense Health Agency (DHA), Demonstration, Tricare Management Activity (TMA), Tricare Overseas Program Philippines | 5 Comments

1 March 15 List of Certified Providers Removed in Secret & ISOS Fraud

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 ISOS conveniently hides from the average beneficiary. Continue reading

Posted in Certified Provider List, Closed Network, Defense Health Agency (DHA), Demonstration, Tricare Management Activity (TMA), Tricare Overseas Program Philippines | 2 Comments

Lying as a Way of Life in the Military and by Their Contractors

For years we’ve watched as the former TRICARE Management Activity (TMA), now the Defense Health Agency (DHA) and International SOS (ISOS) have lied to each other and to the beneficiaries living in the Philippines. Although we have no direct proof that they lied to all the other beneficiaries around the world it seems clear that is a very distinct possibility with very little doubt.

We have many examples of these lies from over the years from all three entities and have in the past posted some, but not all of them, on this blog and in the Newsletter. We were criticized by some for doing this claiming that most of the lies are simple mistakes or inadvertent misstatements by these entities and should be overlooked. We believe the article below has vindicated us. Continue reading

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