It seems ISOS and their front Global 24 have finally come clean on their deliberate misinformation about St. Luke’s Medical Center. It is not going to participate except on an outpatient basis which has yet to be actually posted and assuming we can believe that. Until this happens they apparently intend to offer a blanket waiver to use St Luke’s on an outpatient basis but even that is fraught with major pitfalls; their amateur approach to explaining the program continues to plague beneficiaries and creates more problems than they solve.
For example there is no mention of using any provider’s at St Luke’s and even when St Luke’s is added to the approved list, if it is ever added, that will not change. Under the constantly changing rules of engagement only specific physicians that are listed on the approved provider list can be used. Therefore this waiver has little meaning; you apparently can use ancillary services but nothing else is clear. If the waiver is supposed to mean we can see any physician with an office within the St Luke’s towers, which it clearly doesn’t say, it doesn’t mean the beneficiary could continue to see the provider once this aberration is fully implemented as only those specific physicians that sign agreements with ISOS will play.
This means, in a month or two, that once again beneficiaries will be jerked away from yet another provider and directed to seek yet another provider; so much for continuity of care. Further anyone that makes the mistake of seeking care with one of the yet unknown approved providers at St Luke’s needs to be prepared to pack up shop and find yet another provider at Makati Medical if they ever require inpatient care since St Luke’s will not play the inpatient game with TMA or ISOS. So this appears to be a fix that is really not a fix but a trap.
They apparently are working on getting Baypointe Hospital and Medical Center on Subic Freeport to play but they failed to indicate if inpatient is part of this waiver or not. Again the trap of using providers associated with this hospital, as addressed above with St Luke’s, applies. The individual providers may never be approved as they may not want to play.
Another interesting point is this hospital is not within the boundaries of the demo area known as Olongapo but in a separate area outside that city entirely. This begs the question; did TMA now secretly add Subic Freeport as an additional demo area? If so then that means anyone seeing a provider within this new demo area must use approved providers. If so it appears to be a trick to deny claims as many who live in and around the area planned to use these providers under the current system after 1 Jan 13.
Again, as with everything under this experiment, the buyer needs to be very aware of what the seller is trying to sell!
See Provider Participation Update for the sparse and misleading but so called “official” notice.