Over the last month we have now encountered three, three, different set of access requirements that the TMA experiment is supposed to mandate in order to obtain care. However, to date, none of them have been published for the average beneficiary to follow. But then very little has been made available to beneficiaries on the rules of engagement for this poorly thought out experiment. Here is the latest and we hope the last iteration of this requirement. However, because TMA, ISOS and Global 24 have an extremely poor track record in making policy available to those that have to comply, it is likely even the providers have no idea what they need from beneficiaries in this regard. So be prepared for just about anything.
Thank you for your email. In regards to your query on identification:
It is the host nation provider’s responsibility to validate eligibility as part of the care episode. In order to do this they may request a form of identification that positively identifies the beneficiary. Some examples of identification would include the Military ID or other forms of photo ID such as a local Philippines ID card, or passport. It is not compulsory to show a military ID or local ID for care to be given, however the beneficiary must be able to positively identify themselves to the Provider in order for them to validate eligibility. Just as in the States, if you are unable to be positively identified at the point of care, the provider may choose not to proceed with care or request payment in full.
It is also required when attending the provider that a beneficiary provide the information that the provider will require to enable them to submit the claim on their behalf:
- Beneficiary Contact Details
- Beneficiary Physical Residential Address
- Beneficiary SSN or DBN
The Beneficiary is required to provide a physical address in the Philippines where they are currently residing; a Post Office Box either within the Philippines or the United States is not acceptable. If the Beneficiary is not able to provide a physical address the Provider reserves the right to request payment from the Beneficiary up front for the entire cost of the healthcare being provided. If the Beneficiary is unable to make this payment the Provider reserves the right to refuse care to the Beneficiary.
If the Beneficiary is not willing to provide the other requested information, the Provider reserves the right to request payment from the Beneficiary up front for the entire cost of each episode of healthcare being provided, and the beneficiary would then need to self claim.
Please keep in mind, if providers are not able to positively establish identity and verify eligibility, providers are entitled to ask beneficiaries to pay the full amount for medical expenses at time of service and the beneficiary would be required to file a claim themselves. Therefore, it is to the beneficiaries benefit to assist providers in establishing identity, to avoid having to pay and claim for medical expenses.
For emergency care, an individual should seek care at the nearest appropriate medical facility.
Global 24 Network Services
P.O. Box # 13892
Emerald Avenue, Ortigas Center
Pasig City, Philippines 1605
Toll Free Phone: 1-800-10-4562324
Sent: Wednesday, 12 December, 2012 12:44 PM
Subject: Contradictory Information
A week ago I asked the question below, yet there has been no response. When can we expect an answer as beneficiaries have a right to know what the requirements are to see a provider and given that most policies are not posted anywhere by TMA or the contractor it will take us some time to get to at least some of the beneficiaries.
You claimed earlier;
When seeking care, providers will ask beneficiaries to present their military ID and local Philippines ID card to positively establish identity. If the beneficiary is not able to produce a Military ID the provider may check on the provider portal or call Global 24 Network Services 24 hours a day, 7 days a week for assistance.
1 – You boss Frewen told us military IDs were not required. Are you claiming otherwise now?
2 – The requirement for a second and specifically local Philippine ID is redundant and appears to be in violation of TMA policy. Nowhere in the TMA policy manuals, that TMA quoted to us, does it address the need for a “local Philippine ID”. Please provide the policy reference that requires this redundant secondary ID.
3 – Our notification to beneficiaries of these changed requirements has caused a stir and wonder as to who to believe; TMA, ISOS or Global 24. Another issue that has come out is that many beneficiaries do not have a “local Philippine ID”. Are you going to deny them access to care if you can prove the legal requirement under TMA policy?
4 – Please describe what constitutes a “local Philippine ID” under your requirement, referenced in your response to item # 2 above. Please be specific as to the types of IDs and where they can be obtained, the requirements and cost.