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  1. After significant interest in another thread about an emergency hospital stay and it's related cost. I thought I would post this again for newer members and old members that may never have read this. I originally posted this in April 2013. I know there are a lot of new members on here who might be interested in reading about my experiences in regards to the medical care aspects as well as the financial cost involved in an extended hospital stay. Hopefully it will also be a wake-up call to those of you who might not have considered or planned for the possibility of such an event if it happens to you. Those of you who have TRICARE will hopefully gain some solace that TRICARE will pay for major medical expenses. Since my OP was closed, if you have any questions, I will be able to answer them in this new thread. So it will be easier to answer anyone having specific questions, I have cut and pasted the Original Post below: In 2002 I retired to my home state of Florida after serving 32 years in the U.S Coast Guard. I've been living in the Philippines since Aug 2009. I started off in Santa Rosa, Laguna and then a short stay in Bacon, Sorsogon. I've been here in Dumaguete since Aug 2010. Everything was going fine and I was finally getting settled in to my brand new house (rental). On December 5th 2010 I noticed that my fingers were tingling and numb. I went to the doctor, but he checked me out and said it was probably no big deal and should go away in a few days. The next day I spent most of the day running around on my motorcycle and felt fine. That evening I noticed that I was having problem focusing on the TV. When I woke up on the 7th I had trouble maintaining my balance when walking and I had double vision. I knew something was wrong so I went to the hospital emergency room at Silliman Medical Center. They did a CAT scan and x-rays, but everything was fine. They checked me in to the hospital and scheduled me to see a neurologist. She walked in my room looked at me and said I had Guillain-Barré Syndrome (GBS). GBS is a disorder in which the body's immune system attacks part of the peripheral nervous system. Symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs, arms and upper body. These symptoms increase in intensity until the muscles cannot be used at all and the patient is almost totally paralyzed. In these cases, the disorder is life-threatening and is considered a medical emergency. The patient is often put on a respirator to assist with breathing. Most patients, however, recover from even the most severe cases. GBS is rare occurring in only 1-3 out of 100,000 people. If you are interested you can read all about it online. The doctor asked if I could walk. I said sure and got out of bed to show her, but I couldn't stand up. My speech was also becoming slurred. She told me she was moving me to the ICU because there was a good chance I would soon lose the ability to breathe on my own and I would have to be placed on a ventilator. Within 24 hours I was almost totally paralyzed. I could not talk or eat, but at least I could still breathe on my own, well barely with the help of oxygen. Let's just say that by then I was scared. To make things worse, all expenses had to be paid in advance, so my insurance was useless. The drug that I needed to be administered over 5 days cost over P200,000 ($5,000) a day. Thank God for credit cards. At least a new private room was only P2,000 ($45) a day and believe it or not the ICU was even less. After a week in ICU I was breathing better so I was moved back to a regular room. I remained in the hospital until Jan 8th 2011. Total bill for hospital and doctors was about P1,400,000 ($35,000). Considering my drugs were over a million peso, the cost for the hospital stay and doctors was very reasonable. Tricare came through though and reimbursed me for most everything within a few months. When I was released I still couldn't walk or even set up in bed. I couldn't feed myself or chew, had double vision and I had to be taken home in an ambulance. I rented a hospital bed since I still couldn't set up to eat. I started physical therapy 6 days a week. Within two weeks I could set up and transfer from the bed to a recliner. The doctor hoped I would be walking in three months but a little over a month I was on my feet. Slow at first and since my shoulders still did not work, if I fell I couldn't get up by myself. In three months, I've come a long way and my vision has returned to normal. The only real big problems were my balance, hands and shoulders. I couldn't raise my arms above my head and my hands were still numb and tingled. I couldn't even open a bottle of water. As the months passed I could at least do most things for myself again. I still couldn't get up by myself if I fell. Well it’s now been over two years and even though I've come along way, it looks like it could still be months before I am anywhere near back to normal if ever. I can now lift my arms above my head. I can drive and if you saw me walking around the mall, you probably would not know there was anything wrong with me. My hands are still the worse, but hey as you can see I can type. I still can’t write very well and can barely button my shirt. I have problems with doing anything that requires fine motor skills with my hands. I still have a balance problem, so I have to be careful when and where I walk. Much of my body still is numb but at the same time parts like my hands and feet are hyper sensitive. A fine edge makes it fell like a sharp knife against my fingers and if I step on even the smallest object, it hurts and throws me off balance. Having my nails trimmed used to feel like I was having my fingers and toes cut off. It’s better now but still very strange sensation. Anyway that’s enough about my GBS. I've been with the same woman since I moved to the Philippines. I would never have made it through this illness without her love and support. There for a while she was my care giver and even now she has to do things for me. Bing is your typical Filipina, 5’ 1”, 105 lbs., black hair, brown eyes, tanned skin. She speaks 3 languages fluently and understands several others. Her English is better than mine and I always ask her how to spell English words. She is a private person, so I won't say much more about her here. I know I've rambled on, but I thought it was good to let people know what I've been through and how it's possible to survive here even when things aren't going so smoothly. I figure some of you would like to hear from a retired military person who had dealt with a major medical condition and Tricare. With the love of a good woman and a little bit (or a lot) of luck, I've survived. If you have any questions, just ask. Don
  2. https://www.military.com/militaryadvantage/2018/01/02/tricare-ends-unpopular-pilot-program-philippines.html Tricare Ends Unpopular Pilot Program in Philippines Military.com 2 Jan 2018 By Amy Bushatz Tricare coverage for users living in the Philippines shifted Jan. 1 to the same system used in other areas outside the U.S., marking the end of an unpopular pilot program. The program, known as the Philippine Demonstration, started in 2013 as officials attempted to stymie a flood of provider fraud in that country. Rather than allow any provider to become a part of Tricare's preferred provider network as is done in other OCONUS locations, Tricare officials instead "certified" each provider it worked with in the country, officials said. Doing so helped guard against fraud while also making sure providers were qualified, they said. But the approximately 10,000 military retirees living on the country's 2,000 inhabited islands complained that the program forced them to travel long distances, often between islands, to be seen, and created confusion about who and what was covered. Rather than extend the program or expand it to other areas, Tricare officials chose to let it terminate on its originally scheduled date of Dec. 31, 2017. That means Tricare users -- and providers -- in the Philippines will instead use the same overseas Tricare Select system, formerly known as Standard, used elsewhere outside the U.S., officials said.
  3. The two high quality hospitals in Cebu have been secretly tried and convicted of fraud by TRICARE. Extracted from the TRICARE Overseas Blog, http://wp.me/p2Ka0E-aj Chong Hua Hospital no Longer Certified and Not on the Not Used in > 2 Years List On the Philippine Standard front it appears that DHA has secretly removed and sanctioned Chong Hua Hospital in Cebu sometime between 15 November 2013 and 1 December 2013. Last January they secretly removed and sanctioned Cebu Doctor’s Hospital. That means the two quality hospitals in Cebu are no longer available for use. Since neither hospital ever filed TRICARE claims it boggles the mind how they were found guilty of fraud against TRICARE. When a provider simply disappears from the certified list and is not moved to the Not Used in > 2 Years list it is usually a good indicator that they were secretly tried and convicted of fraud by ISOS and/or DHA. In the states providers that have been convicted of fraud against Medicare or TRICARE are sanctioned by not allowing them to participate or be paid by medical insurance companies. Once they are convicted they are placed on one of two sanctioned lists which are available on the internet. The more extensive of these lists can be found on the U.S. Dept of Health & Human Services. This list contains only the names of those that are currently sanctioned and contains 55,864 names mostly from the states but around 100 from overseas. Of those overseas only one is from the Philippines. The TRICARE Sanctions list appears to contain every provider ever officially sanctioned by them as the sanction has expired on a great number of them. This list contains 110 names. All of them are from the U.S. or the Philippines which has 18 of the 110 listed. Of the 18 only 8 are currently active sanctions. But that’s not the end of the story. We know of many Philippine providers who have been removed from the Certified list and apparently tried and convicted of fraud in absentia. DHA apparently found it more convenient and expedient to bypass legal action in favor of their current process. We became aware of this process many years ago. Initially they posted a list of these providers on the TAO-P webpage but within a few months it disappeared. We asked that it be reactivated but were told that DHA was afraid of possible adverse actions they might encounter if the providers were aware they were sanctioned so refused. So for the last five years the identities of these secretly sanctioned providers have been kept secret from beneficiaries. If a beneficiary is unaware of the sanction and uses one of these providers their claims will be denied out of hand but they will not be told the truth about why it is denied. Some indications you’re being had by the system are when you see the claim denied because the provider is not certified and the denial comes within two or three weeks of receipt by the claims contractor. If you inquire as to the reason the provider was not certified you maybe told the provider “died”, “closed their office” or “retired” on some date before the date(s) of care. Since you saw the provider you would obviously know this it false information. Another indicator is, while anyone that submitted bills and receipts for care from a non-existent provider would be investigated for fraud, they will not pursue fraud charges as they know they would be found out. While many of these providers were involved in fraud, like the physicians that ISOS certified as tertiary hospitals so they could file false inpatient claims, we know of others that did nothing wrong and the basis for the claim of fraud was based on local policy or law which local providers have no control over. There is little you can do about this except report it to the affected provider and complain to your congressman. We feel, in the spirit of openness, you have the right to know what is causing you to lose your benefit so decided to publish this now.
  4. This is a link to our latest newsletter. It covers a new and growing threat to access to care which is providers who have been decertified although they are legitimate licensed providers and which result in denial of payment of claims if used. Since DHA and ISOS refuse to provide a list of these sanctioned providers we developed a list of these providers that beneficiaries can access. Provider Certification; The Secret Paperwork Exercise Gone Bad http://us4.campaign-archive2.com/?u=1559742f080d1da5be82951cf&id=b47d3078cb&e=e17a60d378 Jim USMRoP
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