It appears ISOS continues to spit out their lies, for the good of beneficiaries as they claim and apparently with the full knowledge and consent of TMA who must think lying to beneficiaries in the Philippines is “adequate” for them. It also begs the question what else are they lying about if both ISOS and TMA believe that lying to us is an acceptable practice and for our own good! A day after ISOS acknowledged they were lying and we chastised them for it they continued to post the lie, but more strongly now, on the newly posted provider lists.
Global 24 aka ISOS,
You have yet to respond to my email below as to why you think you have the right to LIE or PARTIALLY STATE TRUTHS OR IN SOME WAY MANIPULATE THE TRUTH SO AS TO ENCOURAGE BENEFICIARIES TO DO AS YOU THINK THEY SHOULD.
But you have done it again, acted like GOD! You posted the 15 Jan 13 updates to the provider lists and even after multiple warning you have decided to continue to lie for the good of the beneficiary; how God like of you and how benevolent.
Here is your manipulated lie; a lie to protect us from ourselves: “If you live within the demonstration area, but get care outside of the demonstration area, TRICARE will only cost share the claim if the Provider is Certified.”
Let me see. I live in the experiment so this new policy applies to me. If I leave the confines of the experiment I can only obtain care and you will cost share it if I use a certified provider. So if I go to an area without a certified provider I am not able to obtain care or you will refuse to cost share my claim. If I have an emergency and I can’t get to a certified provider you will also refuse to cost share my claim. So it seems you are pretty much telling me I better stay home or face almost certain loss of my extremely limited medical benefit.
You said: “The wording encourages beneficiaries to use providers off the Certified Provider List, in order to avoid claims being denied because the provider was not able to be certified.”
I think it does much more than that. In your haste to become God and protect us from ourselves with lies you have told us we no longer have even a limited medical benefit if we leave our homes, and you said that not me. In other words you are telling me I should stay home, if I am unfortunate enough to live in the experiment zone, or face possible loss of my limited medical benefit and emergencies are no longer a covered benefit for, not that it has been in the Philippines for a long time, those unfortunate enough to live in the experiment zone. (We know for years you have denied payment of true emergency claims even when the providers were legitimate licensed providers at the expense of thousands of dollars to beneficiaries.)
But while you put out your OFFICIAL version of the truth you tell me in a private email you know what the real truth is; “As was stated in previous emails, there is no change in TRICARE Policy. In order for TRICARE to cost share a claim, the provider must be certified. If the provider is not certified, the claim will be pended and the certification process will be initiated. Once the provider is certified, the claim will be reprocessed. If the provider is not able to be certified, the claim will be denied.” But of course you know better what we should know about the truth.
Put all together it clearly shows that YOU as nothing more than a contractor, think you are entitled to manipulate the truth in ways you feel, as you claim, encourages us to do what YOU want. I seriously doubt your contract covers any such mandate.
I also have to wonder why TMA continues to allow you to spit out these lies and the COR allows you to continue to violate your contract and deliberately lie to Tricare beneficiaries. There appears to be some collusion going on here to hide the truth from beneficiaries and not in just this one instance.
Given your admission that you lie to us to protect us from the truth, one has to wonder how many more lies you tell us about this program to “protect” us from the truth. Things like we really don’t have 24/7 care but M-F 8-5 but you want to protect us from the truth so lie.
Global 24 aka ISOS,
Stating it to me while officially stating the opposite on your official provider lists hardly constitutes a correction to your WRONG information.
Many of us are well aware that many times ISOS is incompetent when it comes to certifying providers and it has been shown by the 45% that lacked required information per the DODIG and it shows in constant denials for legitimate providers, that ISOS calls non-existent because their staff can’t figure out how to go to a proper address or maybe they just wanted to take a break, who knows. We know hundreds if not thousands of claims are denied because of this incompetence. Yet when these claims are denied because the provider does not exist, instead of TMA taking action to charge the beneficiary with fraud for filing a claim that includes obviously faked bills and receipts, they ignore it. Or maybe they also know of the incompetence and find it furthers their goal of denial of claims in the name of fraud so turn a blind eye to it?
You said, “The wording encourages beneficiaries to use providers off the Certified Provider List, in order to avoid claims being denied because the provider was not able to be certified.”
HOW DARE YOU THINK YOU HAVE THE RIGHT TO DELIBERATELY MISSTATE POLICY TO ENCOURAGE BENEFICIARIES TO DO ANYTHING. THAT IS NOT YOUR RIGHT, PRIVILEGE OR ANYTHING ELSE! YOU ARE NOT GOD SO STOP TRYING TO ACT LIKE A GOD.
So once again and for, what, the 6th time now. WHEN WILL YOU CORRECT THE INCORRECT STATEMENT OF POLICY ATTACHED TO YOUR PROVIDER LISTS? I don’t think I can make it any clearer although obviously making anything clear to this company and its management seems to be an exercise in futility.
On 1/14/2013 1:01 PM, Global24NS.Support wrote:
Dear Mr. ,
As was stated in previous emails, there is no change in TRICARE Policy. In order for TRICARE to cost share a claim, the provider must be certified. If the provider is not certified, the claim will be pended and the certification process will be initiated. Once the provider is certified, the claim will be reprocessed. If the provider is not able to be certified, the claim will be denied.
The wording encourages beneficiaries to use providers off the Certified Provider List, in order to avoid claims being denied because the provider was not able to be certified.
Global 24 Network Services
P.O. Box # 13892
Emerald Avenue, Ortigas Center
Pasig City, Philippines 1605
Philippines Toll Free Phone: 1-800-10-4562324
Sent: Saturday, 12 January, 2013 8:06 AM
Cc: Halliwell, Thomas W CIV TMA (US); Ken Gmail; JAMES TICHACEK; Woodson, Jonathan, Dr, (Dir TMA); Gamble, Byran, BG, (Dep, Dir, TMA); Michael FREWEN; Mark ZIMMERMAN; Dir RAO Cebu; Jose Llacuna-Cavite; Terry Gerken (DepDir RAO Subic); Dir Subic RAO; RAO ILOILO; RAO La Union; RAO Cebu; Albert Encarnacion–Davao; RAO Manila; Oscar Smith–RAO Bacolod City; AmericanLegionPost123; ChrisSchrauben; DAVCH3; FRA 111 Batangas; FRA 127 Bicol; FRA 154 Baguio; FRA 171 Laguna; FRA 247 Dagupan; FRA 367; VFW 9892 La Union; VFW11447; VVA887; VFW 2485; Scott M. Simms FRA 367; Tritten, Travis (S&S); Forestell, Francine, CIV, OASD(HA)/TMA
Subject: Re: Certified provider list spreadsheet
Global (ISOS) 24,
It does seem you are hard of reading and hard headed as well. Your mistakes in policy statements continue to confuse and misinform the TRICARE population you are well paid to serve. You have even been informed of you obvious mistakes and errors and not only once but multiple times. Yet you insist on ignoring emails to you and fixing the obvious problems.
While it is obvious you can’t communicate with providers, they still don’t understand your handouts ah extensive training, maybe as clerks you could take the time and correct this error on your spreadsheets. Unless of course you prefer confusion and misinformation to become the hallmark of your short tenure.
Global 24 – Are we hard of “reading”? I’ve explained to you over and over that your statement is blatantly wrong and asked you to correct it. I even went back to TMA and confirmed that the policy has not changed. Yet you insist on publicly placing WRONG information for beneficiaries to read.
Shame on you!
As before please correct your mistakes and do it now!
Also pleas notify me that you have made the corrections.
Global 24, Global 24,
Actually according to TMA, I just asked, we are not REQUIRED to select a certified provider while outside the demonstration area. Time to get your act straight. We can chose any provider. However if the provider is not certified the claim will be held pending certification. If certification cannot be done the claim will not be paid. That has been the policy for at least 8 years.
So please correct your incorrect guidance in the lists and properly state the policy. Also consider a crash course in Philippine TRICARE Policy.
Please provide feedback when you make this change.