Good Enough for the Stepchildren of TMA in the Philippines


The following email was sent to TMA, S&S and local RAOs and local VSOs. Feel free to forward to your particular congressman or VSO representative in Washington. The references to attached documents have been converted to links to those documents.

Ms. Forestell,

Please review the corrupted and unusable spreadsheet ISOS proudly represents as their very best work and what 11,000 beneficiaries in the Philippines are required to use to try to find a provider, attached as Certified_Providers_19Dec2012.xls.

Open the so called spreadsheet to the “Certified” tab. Select any of the sort/filter functions “gray down arrows” along the top and sort the column. Sort it A to Z or Z to A, it does not matter. If you sorted A to Z on Provider Name column please locate “A F GUEVARRA DENTAL CLINIC”; it is the very first record in a properly sorted Provider Name Column. Try it on the “Not Used in > 2 Years” sheet as well; the results are the same.

Can’t find “A F GUEVARRA DENTAL CLINIC”, oh sorry, you are using the an ISOS product and the best you can do is to look down through each and every record until you find it. I know you are a busy woman so will help you, look in row 2,493 but understand 11,000 beneficiaries won’t have the advantage of me hand feeding them the answer.

The truth, Ms. Forestell, is the spreadsheet is corrupt, was built corrupt, and is known to be corrupt by ISOS and their front Global 24. It was corrupt when they posted it on 15 Dec, it was corrupt when they reposted what they claimed was a fixed spreadsheet on 18 Dec and once again when they reposted on 19 Dec. But as you can see they apparently are not capable of fixing their own mess.

I do their quality assurance for them, since neither they or TMA seem inclined to do it so. I discovered the corrupt spreadsheet on the 15th. I notified them and they reposted another corrupt spreadsheet on the 18th and I again did their quality assurance for them and again they made a half hearted attempt and reposted the third corrupt spreadsheet on the 19th. Since then they have ignored my emails informing them that it is still corrupt; I even offered to fix it for them and email the viable spreadsheet to them if they couldn’t figure out how to fix it but they ignored my offer of assistance as well. Presumably, like TMA based on there apparent acceptance of this level of work, they feel corrupt and unusable spreadsheets are adequate for beneficiaries in the Philippines.

Of some interest, which you can’t see directly just from this corrupt spreadsheet is the massive changes in the providers on the sheets. While the professed reason for replacing the spreadsheet on the 15th with one on the 18th and again on the 19th was to fix the corruption they also made major changes to the number of providers on the lists. The change in the numbers of providers was almost 100 on the certified list. How can anyone rely on this contractor’s information when it is so corrupt and consistently changes with the wind. It was even worse with the corrupt approved provider list where 25% of the providers listed on the 15th apparently changed their minds and withdrew their agreements as they were gone on the 18th. ISOS and their front Global 24 have refused to address these changes by ignoring emails requesting an explanation. So we are left to assume 25% of the providers left the program in mass or once again ISOS and their front Global 24 made huge errors and secretly tried to correct them, hoping nobody would notice. See Providers Now you see them now you don’t.pdf attached. (I have the other spreadsheets and can prove these figures.)

The search engine is useless for obvious reasons and you saw the latest example, emailed to you yesterday, in a parade of feedback emails to ISOS and their front Global 24 pointing out how it still fails to work; it has not worked for more than a year as TMA should be well aware.

My questions and I would like answers; Does TMA and the COR believe this level of quality is what they expect from this expensive contract? Do they believe that the beneficiaries deserve any less in quality products from this contractor than other beneficiaries anywhere else in the world?

Thank you for your time and I am waiting for a response,

About TRICARE Overseas Philippines

We are U.S. Military retirees working to insure we obtain the medical benefit promised in spite of the Defense Health Agency.
This entry was posted in Certified Provider List, Closed Network, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines. Bookmark the permalink.

6 Responses to Good Enough for the Stepchildren of TMA in the Philippines

  1. firstsgtmike says:

    TMA is meeting with selected beneficiaries in the demonstration areas next month. I suggest that a TMA representative be challenged to locate a provider on their list and accompany a beneficiary representative to the providers location. (Train, jeepney, taxi????) The TMA rep can then verify the ability of the medical provider to ascertain the eligibility of the beneficiary, and his deductible status. Also the proficiency of the provider in applying the proper codes when applying to TMA for payment.

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  2. jjjddd says:

    I have been on this Tri CareLess certified\approved list for hours! Dec. 19 update\22 Dec..! It is still not functioning! Unusable to find a certified \ approved or what ever doctor! Well the “high hot’ in tots” will be here the 2 Nd. week of January!
    They better hope the Aircraft & THE Aircraft Mechanics on the particular Airliner they are flying did not use the same Tech Writer to write the Aircraft Maintenance Manuals to Work on & Repair! That wrote\writes the Operating Manuals for T.M.A., I.SO.S. and Global 24\7!

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    • The search engine has not worked for years, even before it was migrated to the ISOS web page. It is there so ISOS can claim they met the contract requirements so they can get well paid for building and maintaining it. You tax dollar at work supporting useless private companies.

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  3. jjjddd says:

    And there Newly — Certified \ Approved listings & Search Engine is still not working! & Never has! on December 29Th.. 2012! All day long!
    This is a Prime Example of FRAUD, WASTE AND ABUSE OF THE ACTIVE AND RETIRED MILITARY MEMBERS\ PERSONS AND THE HEALTHCARE & OR LACK OF IT THAT THEY RECEIVE FROM THESE “GOVERNMENT CONTRACTORS” — WITH THE MONEY OF THE RETIREE & THE STILL WORKING TAXPAYER!
    THAT THEY FREELY ACCUSE THE HONORABLE RETIREES OF IN THE PHILIPPINES! DAILY!

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  4. wgraue says:

    Remember this S&S release below?
    Considering the time and effort and one inutile and stupidly comical meeting held in the usual remote location, after all this time what do we actually see accomplished? Factors have been shuffled around the chart of fraud evidence, but actually, overall, and in actual substance, not a danmned thing! Mick and Mark, in their true disinbenuous fashion have done what to correct major flaws which stop the system from operating? Nothing but lies!

    “CAMP FOSTER, Okinawa — Military insurer Tricare is getting ready to overhaul its troubled health coverage system for U.S. veterans in the Philippines, but the upcoming changes are already drawing strong criticism from some beneficiaries.

    Veterans say a new closed network of Philippine health care providers — set to go online Jan. 1 — is riddled with problems and unanswered questions. They are urging Tricare to quickly pull together a retiree panel to direct improvements.

    The agency said Friday it has fully explained the system and denied troubles are looming. It decided in 2011 to try a closed network after struggling for years to reduce fraud and complaints from about 8,000 military beneficiaries in the Philippines who say red tape during claims processing has often blocked them from receiving full reimbursements for covered expenses.

    The agency unveiled details of its three-year pilot project during presentations to retirees in Manila, Subic Bay and Angeles City in late October, but the events did little to assuage concerns, said Mike Garcia, director of the Retired Activities Office Manila.

    “The people they sent here to present the Tricare project didn’t know anything about the Philippines. They think it is just like the U.S.,” Garcia said. “I don’t think they will be able to put it [the closed network] in place by January because of all the questions and concerns.”

    The closed network of hospitals and doctors was designed so veterans would no longer have to pay medical bills upfront or file their own reimbursement claims with Tricare, a requirement that has caused confusion over differences between U.S. and Philippine documentation and resentment over rejected or delayed payments. Instead, the providers who have joined the new closed network are supposed to explain benefits to veterans and file claims directly with Tricare so full, upfront payments are no longer necessary.

    There are six hospitals and 71 doctors included in the first phase of the pilot project, according to the approved provider list published by Tricare.

    The experimental network will be phased in beginning in January to include veterans in Manila, Angeles City, Subic Bay and Orion. The second phase will open in January 2014 in areas of Cavite, while the final phase will include Iloilo City, Tricare has said.

    After three years, the agency plans to review the performance and decide whether to adopt it permanently in the Philippines.

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    “What’s going to happen is it’s going to fail,” said Ken Fournier, a former servicemember who has spent years helping other Philippine retirees with Tricare grievances and pressing the agency for changes to its system. “The issue of travel time is a big one.”

    Fournier, who has become an unofficial representative of Philippines beneficiaries, said many worry they will be forced to travel long distances to reach participating hospitals and doctors, which could be expensive for those on fixed incomes or those without a vehicle.

    For example, the closed network includes just one general hospital in metro Manila, meaning up to four or five hours of travel in some of the world’s worst traffic, he said.

    Meanwhile, Fournier said many questions remain on issues such as hospital admissions, waivers and the closed-network boundaries. He submitted a list of questions to Tricare management following the Oct. 30 public meeting the agency hosted in Manila.

    “If I go to the hospital, who do I go to see to sign in as a Tricare beneficiary?” he said.

    Fournier is requesting the agency create a working group made up of representatives from Philippines retired activities offices, veterans groups and online retiree groups that focus on the Tricare issue.

    “We offered to sit down and show them how to make it work,” he said. “We are not interested in being adversaries; we are interested in being partners.”

    In a written response to Stars and Stripes, Tricare denied veterans will be forced into long commutes or that it has not done enough to educate beneficiaries.

    “Travel times have been considered in the recruitment of providers,” Tricare spokesman Austin Camacho wrote. “Beneficiaries may choose to drive to see approved providers but because it is locality based, four- to five-hour drive times are not required.”

    Camacho said the agency sent a letter explaining the closed network to all beneficiaries in the Philippines who have filed a claim in the past two years and also conducted the briefings last month, which were held in areas that used to host large Navy and Air Force bases and still have some of the highest veteran populations. Tricare also has posted online information showing providers, area maps and step-by-step instructions on how to use the network.

    The agency will not create an advisory working group of retirees because it already considered veterans’ input when developing the network, but the agency’s local contractor is planning a new round of meetings with retired activities offices in the coming months to further discuss the pilot project, Camacho said.

    trittent@pstripes.osd.mil

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