Hospitals and Other Medical Facilities | Doctors

Hospitals and Other Medical Facilities

Our dedicated Provider Relations team works with our customers and other partners to identify the top expatriate destinations throughout the world, in order to develop direct—settlement agreements with quality hospitals and other medical facilities.  Direct-settlement arrangements allow facilities to accept payments directly from AGB, so our members can better manage their out-of-pocket expenses and concentrate on their health.

These arrangements benefit medical facilities through streamlined admissions procedures and expedited payment processes. More on what is a Direct-Settlement....

Advantages

Joining our provider community gives your facility many advantages, including:

• Providing verification of benefits prior to hospital admission and/or procedure
• Dedicated International Provider Support Specialists, 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, wire or electronic funds transfer
• 24-hour support: Our 24/7 International Service Center offers multilingual service representatives who can confirm eligibility, verify benefits, check claim status and more
• Adding your medical facility to the AGB website: A profile of your facility, including any information you provide such as services available, statistics or awards, will be featured in our online provider directory
• 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:
   1. AGB Customer nominations and recruitment requests received from members living and working abroad.
   2. Nominations from Aetna Institutes of ExcellenceTM providers that have affiliations with international providers. For example, Sanatorio Otamendi (Buenos Aires, Argentina) is affiliated with Duke Medical Center.
   3. Joint Commission International certification or other accreditation governing bodies.
   4. Provider self-nomination.
2. Qualifications. Facilities must meet all of the following standards to be included in the AGB Global Provider Community:
   1. Affiliated physicians and ancillary health personnel are properly licensed to practice medicine in the country where the facility is located.
   2. No previous or current fraud, sanction or debarment issues documented within the Aetna Provider Systems.
   3. English language capabilities within the facility.
   4. Experience with international patients.
   5. Willingness of the facility to accept direct-settlement payment from Aetna Global Benefits on patient’s behalf.
   6. 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:
   1. Warrant by contract compliance with all applicable Federal, National, Provincial, State and Municipal laws and regulations, including appropriate licenses.
   2. Affiliated physicians and ancillary health personnel are properly licensed to practice medicine in the country where the facility is located.
   3. Provide discounts or preferred rates to Aetna Global Benefits’ members, when applicable.
   4. Cooperate with AGB care management process, including grievance complaints and appeals.
   5. 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:
   1. Admissions contacts
   2. Key equipment and services provided
   3. # of beds, physicians and nurses on staff
   4. Emergency room staffing, where applicable
   5. Additional Language Capabilities
   6. Facility licenses, accreditations and honors
   7. 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-settlement partners. In addition, AGB and direct-settlement 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 meet the minimum 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-settlement 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:
   1. Certification by the American Board of Medical Specialties.
   2. Membership in selected Royal Colleges of Medicine or Surgery, including those based in the UK, Ireland, Canada, Australia and New Zealand.
   3. Recommendation and/or request for recruitment by Aetna Global Benefits
   4. 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:
   1. Doctors must certify that they are fully licensed to practice medicine in their country.
   2. 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.
   3. 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.