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Health Care Professionals: Resources: What is Direct Pay?

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"Direct Pay" refers to arrangements that AGB has established with leading hospitals and clinics throughout the world to facilitate admissions and payment processes for our members. When a AGB member accesses care at an AGB contracted “Direct Pay” medical facility, their out-of-pocket expenses may be reduced because they would generally be responsible for a smaller portion of the bill and AGB would pay the facility directly for any remaining covered expenses according to the patient’s insurance plan.

Our goal is to provide our members with convenient access to health care wherever they are in the world. This includes helping them to manage their out-of-pocket expenses for higher-cost treatments such as inpatient hospitalization, complex medical procedures and emergency care. As such, our strategy is to develop direct pay partnerships with leading international hospitals and other medical facilities in the regions of the world where our members work and travel. Based on this strategy, we do not offer direct pay to individual doctors for generally lower-cost health care expenses such as routine office visits for check-ups or exams. In these instances, patients would be responsible for paying the doctor directly and then submitting a claim to AGB for reimbursement for those out-of-pocket expenses.

AGB members can locate "Direct Pay" facilities for preplanned or non-emergency procedures using our online database. Once they have located a facility, they are instructed to first contact AGB to initiate a direct payment request to the selected facility before scheduling an appointment. Upon receipt of the request from the patient, AGB will process and send a Verification of Benefits letter to the facility if the request is approved.

In the case of an emergency, AGB members are instructed to proceed immediately to the nearest hospital or designated medical facility. If the emergency visit results in a hospital admission, AGB will work with the facility and the patient to initiate a direct pay on the member’s behalf.