International Health Care Facilties

The PROTECTIVE ASSOCIATION has direct billing arrangements with health care facilities in foreign countries. The health care facilities agree to accept assignment of benefits for specified services rendered. Please make sure to show them your current FOREIGN SERVICE BENEFIT PLAN ID card prior to making your appointment. The Plan pays them directly if you authorize it. In many cases, the health care facilities bill the Plan for you. Otherwise, they may ask you to send us the bill. You do not prepay the bill, which is the purpose of our arrangements. You are responsible for any balance after the Plan's payment.
 

While most of the health care facilities have direct billing arrangements for inpatient hospitalization only, several have arrangements for inpatient hospitalization, complete maternity care, routine annual physical exam, all covered charges and/or urgent care facility.
 

In addition to the health care facilities listed on these pages, most SEVENTH-DAY ADVENTIST HOSPITALS AND CLINICS in foreign countries participate in our direct billing arrangement.

If a health care facility requires you to submit a claim yourself, please use our secure electronic claim filing system to make sure your claim is delivered to us promptly. It is important that you assign benefits to the health care facility. Simply scan the claim into your computer (as a PDF). Then, go to our secure Member Portal at: https://secure.myafspa.org/ to file your claim. We generally process the claim within 10 business days after receipt.
 

If you have questions or encounter any problems, please contact us by e-mail at [email protected] or call us at (202) 833-4910.

SPECIAL INSTRUCTIONS FOR OUTPATIENT CLAIMS
 

Some of the health care facilities have agreed to bill us directly for outpatient claims. Because many do not balance bill for charges after the FSBP makes payment, they need to know how much to collect from you at the time of service when your calendar year deductible and the 10% coinsurance are involved. They will need to verify coverage and obtain deductible status for you from the FSBP. To take advantage of this arrangement, we highly recommend the following process for outpatient services:
 

a) Inform the health care facility that you are covered by the FSBP prior to your visit, with enough time for the facility to verify coverage and obtain the deductible status from the Plan;

or

b) Show the facility admissions/billing office the amount of calendar year deductible left to be met (if any) using the Coventry Mobile Phone App/Benefit Usage screen on your smart phone;

or

c) Bring a copy of the most recent Explanation of Benefits Statement (EOB) that shows your deductible status.
 

If you do not provide the information above, then the facility will collect the $300 deductible and 10% coinsurance and submit the claim to the Plan marked 'Member Paid'. If you have met all or part of the deductible, then the claims payment will be split between you and the facility accordingly.