Healthcare Professionals: Resources: Become a Provider

Hospitals and Other Medical Facilities

Our dedicated Provider Relations team works with our customers and partners to identify top expatriate destinations throughout the world in order to contract with quality hospitals and other medical facilities to accept payments directly from AGB on our members’ behalf. These arrangements benefit the medical facility because it establishes admissions procedures and expedited payment processes. It benefits your patients because it means reduced out-of-pocket costs allowing them to concentrate on what matters most: their health and well-being.

Advantages

Joining our provider community provides your facility with many advantages including:

• Providing verification of benefits prior to hospital admission and/or procedure
• Dedicated International Provider Support Specialist to provide you with account-specific support including researching claim status and answering payment or eligibility questions.
• Easy claim submission process: via fax or postal service
• Prompt payment in multiple currencies: Your choice of payment in U.S. dollars or your local currency via check or wire or electronic funds transfer
• 24 hour support: Our International Service Center provides you with 24 hour, multilingual service representatives that can confirm eligibility, send you a verification of benefits, check claim status and more.
• Promotion of your medical facility via the AGB website: Your facility will be listed in our online directory and will include statistics that you provide to us regarding services, awards and other profile information.
• Direct referral of patients to your facility by an online web search tool

Recruitment and Qualifications

1. Selection. Facilities are considered for partnership in any one of the following ways:
   • AGB Customer nominations and recruitment requests received from members living and working abroad.
   • Nominations from Aetna Institutes of Excellence^TM providers that have affiliations with international providers. For example, Sanatorio Otamendi (Buenos Aires, Argentina) is affiliated with Duke Medical Center.
   • Joint Commission International certification or other accreditation governing bodies.
   • Provider self-nomination.
2. Qualifications. Facilities must meet all of the following standards to be included in the AGB Global Provider Community:
   • Affiliated physicians and ancillary health personnel are properly licensed to practice medicine in the country where the facility is located.
   • No previous or current fraud, sanction or debarment issues documented within the Aetna Provider Systems.
   • English language capabilities within the facility.
   • Experience with international patients.
   • Willingness of the facility to accept direct pay payment from Aetna Global Benefits on patient’s behalf.
   • Meets all Federal, National, Provincial, State and Municipal laws and regulations, including appropriate licenses.
3. Contracting. Facilities must enter into a contract with Aetna Global Benefits specifying the terms of their participation in the Community. Each contracted facility agrees to the following:
   • Warrant by contract compliance with all applicable Federal, National, Provincial, State and Municipal laws and regulations, including appropriate licenses.
   • Affiliated physicians and ancillary health personnel are properly licensed to practice medicine in the country where the facility is located.
   • Provide discounts or preferred rates to Aetna Global Benefits’ members, when applicable.
   • Cooperate with AGB care management process, including grievance complaints and appeals.
   • Treat medical records as confidential.
4. Profile Submission. Qualifying facilities must submit a detailed profile to Aetna Global Provider Services. Information submitted includes, but is not limited to:
   • Admissions contacts
   • Key equipment and services provided
   • # of beds, physicians and nurses on staff
   • Emergency room staffing, where applicable
   • Additional Language Capabilities
   • Facility licenses, accreditations and honors
   • Affiliations with United States or United Kingdom Universities and Medical Centers
5. Provider Relations. The AGB Global Provider Community is maintained through a dedicated Provider Relations Department that handles questions or issues that arise with the facilities or direct pay partners. In addition, AGB and direct pay partners are proactive in the outreach to the facilities regarding Aetna Global Benefits programs and members.

Become a hospital partner

To become an AGB provider partner, you must at minimum meet the criteria listed above and complete an application for review. Participation in our provider community is voluntary. AGB neither requires nor accepts fees from contracted hospitals or other medical facilities.

Doctors

To develop our international doctor community, we’ve partnered with HTH International, a leader in global health and safety services. Participation in the international doctor community is by invitation only. HTH neither requires nor accepts fees or payments of any kind from health care providers. Please note that AGB does not establish direct payment procedures with individual doctors. Exceptions may include if the expense is in conjunction with a hospital admission or specialized outpatient procedure such as an MRI, CT Scan or surgery.

Recruitment and Qualifications

1. Provider Selection. Providers qualify for participation in any one of the following ways:
   • Certification by the American Board of Medical Specialties.
   • Membership in selected Royal Colleges of Medicine or Surgery, including those based in the UK, Ireland, Canada, Australia and New Zealand.
   • Recommendation and/or request for recruitment by Aetna Global Benefits
   • Personal recommendation by an HTH Regional Physician Advisor, Medical Officer or Post Medical Advisor for U.S. or British diplomatic missions, HTH staff person, or the Medical Director of an HTH participating medical facility.
2. Biography Submission. Qualifying doctors must submit a biographical profile that is reviewed by HTH's provider relations staff. This biographical data is subsequently updated on an annual basis. Contact information is updated bi-monthly (see Step 4 below).
3. Contracting. Doctors must enter into a contract with HTH Worldwide specifying the terms of their participation in the Community. For example:
   • Doctors must certify that they are fully licensed to practice medicine in their country.
   • Doctors must certify that they have received post-graduate medical training in US/European (Western) style medicine at an internationally accredited hospital or medical center.
   • Doctors must certify that they are fluent in English.
4. Ongoing Communication. The Community is maintained through an average of eight annual communications between HTH Worldwide and each participating doctor, in addition to communications that pertain to specific customers and patients. A Community newsletter, called the HTH Compass, is published bi-monthly and distributed to each doctor.