The latest “Certified” list was posted by International SOS (ISOS) on 1 July 2014. We reviewed the list for suspicious removal activity. The providers we are concerned with were not moved to the Not Seen in > 2 Years list. This means beneficiaries used these providers during the last 2 years yet they secretly disappeared if you believe the notice in their webpage. While it is possible that they died or retired we find that is not the case with most of the ones we researched. So the removals are extremely suspicious and appear to involve the secret sanctioning process that is only conducted against providers in the Philippines; every other beneficiary anywhere in the world can access a list of sanctioned providers in their area. In the Philippines the Defense Health Agency (DHA) prefers beneficiaries play their game of Russian Roulette!
These are the results of our review:
Fifteen (15) providers simply disappeared in secret and under suspicious circumstances.
There were no corrections to any of the current errors included on the list. Of note however is a new error on a newly added provider. As usual their outdated and 20th century IT department is using free-hand data entry and the kid that was doing the entry apparently had no idea in what province Talisay City is located so left the field blank.
By failing to use industry standard name conventions they have insured that their search engine will not function properly and their data will not be easily searchable using industry standards. Maybe that is done on purpose to make it harder for beneficiaries to find information and to hide their continuous data errors.
We continued to notice an increasing trend that does not bold well for Philippine TRICARE beneficiaries forced to use the limited access Demo.
That trend is what can arguably be called ‘Scraping the bottom of the barrel’, to find any provider that will agree to being ‘Approved’.
During the first briefing on this experiment we asked International SOS’s Frewen what quality checks were being done on providers added to the Approved list. His response was only Certified providers were considered. When questioned why certification constituted any kind of quality check he responded because only providers Philippine TRICARE beneficiaries used in the past were certified and therefore they must be the better quality providers.
While in an abstract way this might have some validity, then the opposite must also be true. The opposite being providers who are not certified because no beneficiaries used them or refused to use them based on what they heard about them are of low or questionable quality.
The latest Certified list includes new certified providers, who also appear as new approved providers in the Demo areas. Obviously the majority of these were not certified because a beneficiary decided to see them and file a claim in the Demo areas. So it appears they were certified so they could be approved; kind of putting the cart before the horse if one cares to believe Frewen’s quality claim. However the numbers are dwindling so maybe they have literally scraped the last residual of questionable providers from the bottom.
Bottom line, ISOS and the Defense Health Agency (DHA) seem to be willing to renege on any promise or any safeguard regardless of the adverse consequences to beneficiaries to force this experiment to continue.
A new trend we are seeing is a growing number of what Approved providers quietly being removed from the Certified list as well as the Approved list. So it appears more and more providers, even if ISOS bribed them with higher fees, are abandoning not only the Demonstration but want absolutely nothing to do with TRICARE and what they see as fraud. This doesn’t bode well for beneficiaries as the already limited pool of providers are being cut even more due to the poor quality of support and convoluted rules providers find with TRICARE. The latest loss is CARMEN MENCHU DEANG LIWANAG SKIN CLINIC at AUFMC.
And finally Frewen’s staff has decided to reduce access to care even more by removing the ability to easily filter/search the Excel Approved and Certified provider files. Until a couple of months ago and for years these lists were set up so that the average user could do basic filtering. But now users must first learn how to implement filtering, apply the technique and save the modified file. Maybe current IT staff no longer knows how to do this so it was removed due to lack of knowledge and not with malicious intent? If you don’t know how to add this feature back you can find instructions at How to Use AutoFilter in MS Excel.
See List of Secretly Removed Certified Providers. It can also be accessed from the TRICARE Overseas Philippines blog’s “Useful Links” on the right under the same name. It lists all providers removed in secret and under suspicious circumstances since 1 July 2013.
We also caution beneficiaries that providers listed on the certified and/or approved list my not really be certified or approved and ISOS admits this by virtue of their published disclaimer. In addition beneficiaries have attempted to use approved providers who denied they were approved. As with everything ISOS, buyer beware!
Never forget the Defense Health Agency and International SOS always have your back when it comes to high quality and easy access to care; just ask them!