International SOS is Once Again Dumbfounded Over Local Health Care Industry Practices


Between International SOS’s (ISOS) lack of real feet on the ground and their local hires that are poorly trained in TRICARE and know even less of the local industry, they werPhilhealthe once again dumbfounded when we brought to their attention that Demonstration providers were throwing TRICARE beneficiaries out on their ear if they discovered they had Philhealth, telling them they were not eligible to use the Demonstration and had to pay cash and submit their own claims; we know of at least two instances of this discrimination fostered on beneficiaries because of ISOS’s  lack of forethought and lack of qualified people working on the experiment.

Beneficiaries are caught in the middle of this inexcusable and impossible failure on the part of ISOS to do their job. The TRICARE Management Activity (TMA) also shares in the blame because they hired and turned lose this company that appears to be more interested in profit and advising providers to increase their fees 2 to 5 times over normal local rates to other third party payers and cash patients than doing the job they are hired to do. We’ve addressed multiple other examples of this negligence in the past but persistence and months are required to succeed; “Stupid is as Stupid Does” comes to mind. Mostly we find both are in a state of denial and refuse to accept facts and reports from multiple beneficiaries but instead listen to what should be obvious lies from their local hires that generally haven’t a clue. Or they throw out 10 complaints, and then hold up 1 complement as the norm to TMA who is also gullible. We won’t go into the multiple examples of how these local hires miss-taught TRICARE policy to local providers and failed to teach them vital aspects of the program that will ultimately result in the collapse of the entire experiment. Every beneficiary has seen at least one example of this failure when they were told a married sponsor has a personal deductible of $300 or that flu shots are not an authorized benefit. Or told emergency care requires preauthorization from Singapore or when they find the provider list used by a facility is 2 months old and fails to contain the doctor they came to see and when they suggest that the facility check it on the internet, get a deer in the headlights look from the facility employee and the ISOS local hire trainer.

It has become obvious that ISOS is not even aware of the long standing process we set up years ago with the assistance of TAO-P for Philippine TRICARE Standard. They have no idea there is a long standing form that the provider and beneficiary completes and signs which is then included with claims sent to the claims processor but even their subcontractor for claims processing knows more about it than they do. TMA even has a webpage dedicated to this form and its use, Philippines Itemized/OHI Claim Checklist. One can even download the form from this location, Philhealth Claim Checklist. We can only wonder why ISOS doesn’t seem to be aware that information on Philippine TRICARE Standard is readily available on the TMA website. A program they and TMA scream to the rooftops is still the program we use, except with no choices to choose a provider.

Given that the process and form is already in place and even if ISOS again missed the boat, it shouldn’t take them more than a day to clue their local hires into the process who should then train their contracted physicians and hospitals in its use. Then the beneficiaries who have been disowned by their own promised health benefit could actually get care; a novel thought. Given that local physicians and hospitals deal with Philhealth thousands of times a day it really shouldn’t too long to get them up to speed on this simple form.

But here we sit, more than a week later, still waiting for the dumbfounded ISOS to get it together. Maybe this simple form and the concept of Philhealth are too complex for ISOS to get their arms around. In the meantime honest and sick beneficiaries, who are forced against their will to use this poorly designed experiment, find they no longer have access to care. That is criminal and someone should take action against those responsible for this and the other failures.

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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 Closed Network, Emergency Care Access, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines. Bookmark the permalink.

6 Responses to International SOS is Once Again Dumbfounded Over Local Health Care Industry Practices

  1. Awful service, but par for the course where G24 and ISOS play.

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  2. jjjddd says:

    INTERNATIONAL SOS! IS BLIND! THEY CAN NOT SEE YOU! THEY ARE DUMB AS THEY CAN NOT HEAR YOU! THEY SPEAK WITH FORKED TONGUE: AND NOT WORTHY OF LISTENING TOO ANYMORE!

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  3. firstsgtmike says:

    What has become more obvious every day is that NOBODY CARES. Those of us that are affected can post, demonstrate, and provide irrefutable proof. The response, or lack of, denotes an attitude of “So What?” “Who Cares?” “WE are GOD, superior to Congress and the President.” “Please die in peace, and don’t bother us again.”

    Recent history has proven, beyond a shadow of a doubt, that they are right.

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  4. wgraue says:

    I may be intruding by posting this here, I posted it on the “Bamboo Bugle,” whose filter finally hacked me off, so it can go back to the bamboo for all I care. You want experiences? I’ll tell you about my first one, now history.

    It may be “It is what it is” today, but it doesn’t mean it’ll stay that way! If we don’t change it it’ll only become worse and more disgusting tomorrow. The above claim history is typical. It took over 4 years to finally settle all of my claim with an emergency treatment for ischemic stroke in Angeles City, (whose AUFMC ER did nothing but charge P2,500.00 before informing us that they “don’t treat PTSD patients, thank you,”) and subsequently at Mt Carmel in San Fernando Pampanga, which sent me to Heart Center hours after my arrival. Had I not received a lot of assistance from an authoritative and dedicated individual who knows the ropes in Tricare, I would have received about 6% of my claim.

    TMA/ISOS are nothing if not con artists, ‘flim-flam’ individuals stealing the retirees blind. They lie so often one would have to hook them up to a ‘truth detector’ to note any change in their behavior. I emerged with a pacemaker , around $17,000.00 poorer, and then began the Tricare red tape machine. Of that money around $15,000.00 was actually for medical expenses. BTW, first rate medical facility, great care, nurses bare watching, private rooms all the way, just try to do that in the states and walk out for that price!

    Procedure was somewhat complicated by WPS/TMA declaring they had never received my claim till I transmitted it a second time, then both claims magically appeared and the poor dears cried out that they were confused. So was I, but thanks to a good Samaritan, Jim, giving a lecture about Tricare benefits to a largely disinterested audience in an American Legion post garden, I’d have been robbed forever. Thanks to jim, I finally after many white collar battles and his great and unyielding efforts, received nearly what I should have received. I have no gripes. I consider him a true friend.

    In the ‘Bamboo . . .’ never mind, a complaint was filed about a patient being denied the whole claim because the doctor prescribed pre surgical admission the day before the cutting. My question would have been, had I not proved too dumb to know how to operate their system,

    “Pre-surgical admission not admissible on a claim? Did they say why? They probably coded it with a non-existent number and then said that coded number is a secret. The same thing was prescribed for me so I could be ‘worked up’ and prepped for surgery earlier this year, I went the next day as if I never got that part of the prescription, and the surgeon decided I did not need the surgery anyway, since I had begun to recover without it, and second opinion biopsy was negative as the first.”

    That is TMA/ISOS for you, they get your money and you get the ‘wood screw,’ because they ‘would screw’ anyone.. They’ve devolved from bad to worse, and have demonstrated that while in free fall, they haven’t hit the bottom of the shaft yet. They sure give us the shaft enough, though, I think we all have hemorrhoids from it.

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  5. wgraue says:

    A slight corection to my statement. The “Claim above” to which I refer was one narrated in that blog, and I could for some reason not copy it suyccesfully, it is an editing error on my part.

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  6. fern says:

    International SOS is led by poor quality managers.
    Dishonesty is a part of their corporate culture.
    Their predatory practices need to be more publicised.

    Like

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