Q: How do members outside of the U.S. know which providers are closest to them?
A: Seven Corners’ Assist Department is available to answer questions regarding our International Provider Network. Once a customized network has been set up, members also can access the customized provider directory specifically designed for that network via a web portal.
Q: What happens if a member pays their claim upfront and needs reimbursement?
A: Seven Corners gives its members ID cards that provide the necessary information for filing a claim outside of the U.S.
Q: What methods of claims payment are available?
A: Seven Corners’ contracted providers submit bills directly to Seven Corners, and Seven Corners submits payment to the provider for the portion of the service that is a covered benefit and the responsibility of the carrier. Members are responsible for payment of non-covered services, co-pays, deductibles, etc. If this is managed through a Seven Corners travel medical insurance policy, the payment to the provider comes from Seven Corners’ funding rather than the U.S. carrier, health plan or employer.
If a provider does not have an existing contract with Seven Corners, we will attempt to work directly with the provider for guarantee of payment if we are notified prior to the scheduled visit. If a member is required to make full payment at the time the medical services are rendered, Seven Corners will reimburse the member for covered benefits that are the responsibility of the funding organization (carrier, health plan, employer or Seven Corners, if travel medical insurance is purchased through us). Members are responsible for payment for non-covered services, co-pays, deductibles, etc. Paying at the time of service will not affect the negotiated rate, if a negotiated rate has been established. Members must submit the appropriate form with a copy of their medical bills.
Q: How extensive is Seven Corners’ international provider network?
A: Seven Corners has an established network of thousands of international health care providers – and the network is always growing. We do not provide our clients with a detailed list of providers until a contract has been signed. However, we can provide numbers and specialties by city, and we often build networks based around specific location needs. We also provide references from clients for whom we have developed customized international provider networks.
Q: How is air ambulance service covered?
A: Seven Corners has an internal assistance unit that coordinates evacuations and repatriations. Additionally, we are contracted with an outside assistance specialty company that works with us to obtain the most competitive air ambulance provider arrangement for each specific case.
Q: What is Seven Corners’ referral or provider contracting criteria?
A: Seven Corners utilizes its proprietary country profiles to determine provider quality standards as well as international accreditations.
Q: Why would a U.S. company need international provider access?
A: Typically U.S. coverage does not cross international borders for traveling employees, employees who are living outside of the United States, or employees who are citizens of another country. Additionally, coverage does not provide for steerage to quality health care providers outside of the United States. Seven Corners solves this issue by allowing U.S. commercial carriers or employers to access our non-U.S. provider network, which consists of quality doctors and hospitals throughout the world.
Q: Seven Corners states that it pays in foreign currency. Is that necessary?
A: Payment in foreign currency is required by most international health care providers. By paying our providers in their country’s currency, Seven Corners can ensure a quicker and more reliable claims process for you and your employees.
Q: How are foreign claims processed?
A: Seven Corners translates claims and converts to U.S. coding standards for reporting purposes.