Overseas Providers

FSBP considers all providers outside the U.S. and Guam (including Military Treatment Facilities) as if they are in the Plan’s network. We provide the same coinsurance rates as we do for in-network providers.

We generally consider foreign providers’ charges as billed. However, we reserve the right to request information that will enable us to determine medical necessity or an allowance on charges we deem to be excessive.

Overseas Direct Billing Arrangement (DBA) Partners

As part of AFSPA’s commitment to “Caring for your health worldwide,” FSBP takes special care to ensure those working overseas can access healthcare services without hassle or paperwork.

To facilitate care, FSBP maintains direct billing with over 300 healthcare providers across the world including China, Colombia, France, Germany, Great Britain, Italy, Japan, Korea, Panama, Russia, Switzerland and Turkey. Click here to view a list of our Overseas DBA partners. Members must call ahead to the hospital or clinic to confirm participation.

Direct Billing Arrangement (DBA) Overseas Providers & Facilities

If you received care from a provider with whom we have a Direct Billing Arrangement, the only expense you may be responsible for is your deductible and/or coinsurance and any non-covered services. The provider will bill us directly and we pay the provider for covered services. Click here to view a list our DBA Partners.

If you have paid a direct billing provider prior to your claim submission, we request that you provide us with a copy of your paid receipt along with the exchange rate you used to convert the currency. Submit your receipt via our secure AFSPA Member Portal for the quickest processing.

How we process foreign claims

• We will translate your claim(s), if you do not provide a translation.
• We will use the U.S. dollar exchange rate, benchmarked against the rate reported by Oanda (www.oanda.com), applicable on the date the service was incurred, if you do not supply us with a currency exchange rate along with a paid receipt (see FSBP Brochure, Section 7, Overseas claims for exceptions).
• We will accept foreign providers’ charges generally as billed. In other words, there are no reductions to Plan allowance or fee schedules. However, we reserve the right to request information that will enable us to determine medical necessity or an allowance on charges that we deem to be excessive.
• We will process all types of foreign bills as a priority, generally within 20 business days.

Where to submit your Overseas Claims

FSBP pays for claims for providers outside the U.S. at the in-network co-insurance benefit. We will provide translation and currency conversion services for foreign overseas claims services. For more information about this service, click here.

Two ways to submit overseas claims:

ONLINE:

For the quickest processing, submit your overseas claims via our secure AFSPA Member Portal . You are also encouraged to complete an Electronic Funds Transfer (EFT) form. The EFT form allows us to deposit reimbursements directly into your U.S. bank account, reducing paper and time.

BY MAIL:

Foreign Service Benefit Plan 1620 L Street, NW, Suite 800 Washington DC, 20036-5629 Bear in mind, mail to/from overseas significantly increases the time for you to receive claim reimbursements.

Overseas Massage Therapy Claims

The following information is needed on an itemized bill for reimbursement:

• Patient’s name
• Patient’s date of birth
• Patient’s unique “W” ID number (found on the front side of your FSBP Member ID card)
• Full name and address of the provider/massage therapist, including city, postal code and country
• Date of each service
• Description of service rendered
• Cost for each service
• Copy of your paid receipt

Click here for more information on how to submit your massage claims.

Electronic Funds Transfer (EFT)

This is the quickest way to get your claims reimbursement into your U.S. bank account, whether you reside in the U.S. or abroad. Signing up for this service is simple! Complete the EFT Authorization Form in full and submit securely.

Important things to know:

• Only one bank account per family is permitted.
• The EFT Authorization Form only allows the Plan to deposit funds into your bank account. The Plan cannot retrieve funds from your bank account.
• The Plan does not charge a fee for EFT service, but your bank may charge a small transaction fee.

When you receive claim reimbursement via EFT, your Explanation of Benefits (EOB) will be available to you electronically and will no longer be mailed to you. To view your EOB, logon to Aetna’s secure member website. You may opt to have a paper copy of your EOB mailed to you by checking the box at the bottom of the Authorization Form indicating your desire to continue to receive a paper EOB.

24-Hour Translation Line

The Translation Line provides telephonic language translation services in an emergency for our overseas members. 

Dial 855-482-5750, or 704-834-6782, and choose option 2.

Virtual Second Opinion – Cleveland Clinic

The Plan has a special arrangement with Cleveland Clinic to provide a Virtual Second Opinion to patients who receive treatment in foreign countries. This program allows expert specialists from the world-renowned Cleveland Clinic to review your medical diagnosis and treatment remotely. With 3,500 experts in over 550 advanced subspecialties, you can get help with nearly any health challenge.

To request a Virtual Second Opinion for treatment received outside the U.S., simply email secondopinion@aetna.com. You can also click here for the FSBP direct link to Virtual Second Opinions by Cleveland Clinic.  You may be asked to submit medical history and answer questions specific to your diagnosis. You also may need to gather information from your local physician or hospital, such as pathology (biopsy) slides or X-rays, and upload them to the site as instructed.

You will be matched to the most appropriate Cleveland Clinic expert specialist who will review your medical history and original tests before rendering an informational second opinion. You will receive notification by e-mail within five calendar days that the opinion is ready for you to view online via a secure website.

 

Children’s National RSO Program

The Plan has a special arrangement with Children’s National Hospital to provide patients who receive treatment in foreign countries access to Virtual Second Opinions. This program allows you to have your medical diagnosis and treatment reviewed by expert specialists from Children’s National Hospital who can help you with many health challenges.

The Children’s National RSO Program provides patients access to leading pediatric specialists, without ever having to travel outside of their home. For each RSO, our physician reviews the patient’s medical information and compiles their findings into a comprehensive written report.

• Physician to Physician
• Easy Online submission of demographics & studies
• Direct access to a designated clinical & financial teams

Process for Requesting an RSO

• We assign an expert
• Review medical information
• Delivery of complete second opinion packet
• Financial review
• Post opinion follow up

To request a Virtual Second Opinion for treatment received outside the U.S., simply complete the online intake form Children’s National – Online Request Form.