Procedures
- Provider Guidelines
To simplify access to care for our members, we have established pre-defined payment procedures with partner hospitals and other medical facilities around the world. As a contracted AGB facility, AGB will pay you directly for eligible health-related services provided to our members in accordance with their plan of benefits. Members will generally be responsible for a portion of the bill, generally referred to as a “deductible” or “coinsurance.” Our Provider Guidelines outlines the process for requesting a verification of benefits and submitting claims for direct payment from AGB.
Forms
For medical, dental and vision providers:
- Physician’s Statement: (English) (Spanish)
- Dental Provider’s Statement: (English) (Spanish)
- Vision Provider’s Statement (English) (Spanish)
- Provider Payment Authorization Form
- Direct Pay Provider Request Form
Additional helpful resources: