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Home  >  Providers  >  Provider Education Manual  >  Section 3: TRICARE Preferred Provider Network & Provider Credentialing
Section 3: TRICARE Preferred Provider Network & Provider Credentialing
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What is a Preferred Provider?

TRICARE Preferred Providers enter into a formal agreement with International SOS to provide medical care or services to members of the U.S. military. Preferred Providers may be individuals, group practices, hospitals, pharmacies, durable medical equipment providers or other facilities.

Benefits of Joining the Preferred Provider Network

The Preferred Provider Network benefits both host nation providers and the U.S. military. When U.S. military members need host nation care, they are referred to preferred providers whenever possible.

International SOS' Global Assistance Network Management team is available 24/7 to provide information, support and assistance to preferred providers.

In turn, preferred providers offer a number of benefits to U.S. patients:
  • Patients feel confident that are receiving quality care, because preferred providers' credentials have been reviewed.
  • Beneficiaries are more comfortable, because their provider can directly or indirectly communicate with them in English.
  • TOP Prime and TOP Prime Remote beneficiaries can receive assistance in filing claims.
How to Become a Preferred Provider

We encourage you to contact your International SOS Regional Global Assistance Network Coordinator to find out more about joining the Preferred Provider Network. For a full list of phone numbers click here.

Your Network Coordinator will provide you with all the information you need, along with a Mutual Cooperation Protocol between you and International SOS. Once you have reviewed the document, provided the required information (including your credentials), and both parties have signed the Mutual Cooperation Protocol, you may become part of the network.

Examples of credentials include a copy of professional license, proof of malpractice insurance (where applicable), fee schedules and other information.
Preferred Provider Responsibilities

A detailed list of preferred provider responsibilities can be found in the International SOS Mutual Cooperation Protocol.

Preferred providers are expected to follow the guidelines below:
  • Do not discriminate based on sex, race, color, creed or religion.
  • Communicate directly or indirectly with patients in English.
  • Identify and assist TRICARE patients who seek emergency care and properly authorized routine and specialty care.
  • Maintain health records for TRICARE beneficiaries and, whenever possible, make English-language summaries of these records available for inclusion in the beneficiaries' U.S. military medical records.
  • Promptly return consultation results to the referring Military Treatment Facility (Note: Routine consultation reports should be returned within 10 working days, emergency consultation reports should be returned within 24 hours).
Keeping Your Provider File Current

International SOS Global Assistance Network Coordinators are committed to keeping preferred provider files current and accurate. Reviewing this information on an annual basis helps prevent confusion and avoid problems.

Listed below are events that will require a yearly update to your preferred provider file:
  • The address from which you provide care changes.
  • Your billing address or other billing information changes.
  • Your phone, fax, email or other contact information changes.
  • Your office hours change.
  • Your credentials change or are renewed.
In the case of these events, please contact your Regional Global Assistance Network Manager, using the following email addresses below, or click here for TOP Regional Call Center numbers.

Europe, Middle East & Africa:
providerseurasiaafrica@internationalsos.com

Asia Pacific:
providersasiapacific@internationalsos.com

Latin America and Canada:
providerslatinamerica@internationalsos.com

Puerto Rico:
provider.inquiries.PR@internationalsos.com

Preferred Provider Quality Mission

International SOS is committed to delivering quality medical care to all beneficiaries living overseas. By joining the Preferred Provider Network, you can be proud to know that you are part of this mission.

International SOS works with you to understand how problems can be corrected or improved. We also work with you to develop a plan for avoiding quality- or service-related problems in the future.

The Mutual Cooperation Protocol, together with our ongoing development and maintenance of the Preferred Provider Network, helps International SOS ensure our quality performance.

From time to time, you may be contacted by International SOS or TRICARE directly, to assess and monitor your overall satisfaction with TOP, including service, accessibility, provider education and other areas.


TOP Regional Network Managers

A dedicated TOP Regional Global Assistance Network Manager and their respective team of dedicated network specialists is available to assist you. The TOP Network team includes nurses, administrators and quality staff dedicated to TOP. This team is responsible for working with Host Nation Providers in their respective countries, building and maintaining relationships, and answering questions about TOP covered services, authorizations and submitting your claims for payment.


Access to Care

International SOS is committed to ensuring that TOP beneficiaries have access to quality care with suitable wait times and other standards of service delivery. Below is an overview of these standards and guidelines, as established by TRICARE Policy.

TOP Access to Care Standards
Element Definition Service Standard
Wait Time for an Appointment When a TRICARE Prime beneficiary contacts you to make an appointment, you will are expected to follow the guidelines below for seeing the patient:
• Well-patient visit or Specialty Care Referral: 4 weeks
• Routine Visit: 1 week
• Urgent Care: 24 hours
Well-patient: 4 weeks
Routine: 1 week
Urgent: 24 hours
Office Waiting Times When a TRICARE beneficiary comes in for their appointment, the office waiting time to see their clinician can be no more than 30 minutes – unless the clinician’s schedule is disrupted because of a medical emergency. No more than 30 minutes
Availability of Emergency Services Providers of emergency care services are expected to be available 24 hours a day, 7 days a week. Emergency care providers are selected on this basis. If your availability changes, you must notify us immediately. 24 hours a day /
7 days a week

Note: If you have any questions or concerns about your ability to meet these standards and guidelines, please contact International SOS.

Provider Credentialing Process

With 25 years of experience in international health care and medical assistance services, and operations in 70+ countries, International SOS understands that health care delivery differs significantly from country to country.

Factors such as local country legislation and regulations are considered, as well as existing health care infrastructure and any unique challenges that may impact the delivery of care in a specific region.

International SOS takes these differences into account, when reviewing provider capabilities and determining eligibility to participate in TOP. Local Global Assistance Network managers use country-specific credentialing guidelines and we work with host nation licensing agencies, to maintain accurate and up-todate information about local standards.

Provider performance is monitored on an ongoing basis so that potential problems can be addressed before they impact beneficiary satisfaction and quality of care. Provider satisfaction surveys are also used to monitor your overall satisfaction with International SOS, including how accessible or helpful our call center and TOP Network staff is in assisting with claims processing, provider education, and other areas.

The following credentialing items are required to become part of the TRICARE Preferred Provider Network:

Criteria Standards
Signed Provider Agreement An International SOS Provider Agreement (Mutual Cooperation Protocol) must be signed, in order to be part of the TOP Preferred Provider Network.
Meet the Standards for Authorization All health care services for TOP Prime and TOP Prime Remote beneficiaries are provided on an authorized basis. You will be expected to accept International SOS’ authorization for services, and agree to submit Claims and itemized invoices for payment to International SOS, through our subcontractor Wisconsin Physicians Service (WPS). You agree not to balance bill a Prime beneficiary for uncovered services.
Valid Malpractice Insurance (If Applicable) You must have professional liability insurance, if this is required by the laws of your respective host nation. If you are a country, state, province, etc., entity provider, and you are self-insured, then you are not required to have malpractice insurance.
Licensure / Registration You must meet the requirements for licensure / registration as specified by your local Governmental authority or licensing board. This includes having a valid license or registration in the host nation where you practice.
Evidence of Professional Qualifications and Experience You must be a graduate of an accredited program in health care sciences. This includes completing a certificate (residency) program, leading to certification in general medicine, family practice, gynecology, pediatrics, dentistry or other disciplines/specialties recognized by the applicable certifying agency in your country.
English Language Proficiency You must be able to proficiently communicate in English (both verbally and in writing), or to provide English translation and interpretation services at the time of service.


Beneficiary Access to TOP Preferred Providers

All Host Nation Providers with a signed Mutual Cooperation Protocol and approved credentials on file with International SOS will be published on this website and displayed for beneficiaries.

The published list of providers is matched with International SOS' internal database of TOP preferred network providers, so it is important that you keep all of your information up-to-date.

TOP beneficiaries using the www.tricare-overseas.com website have the comfort of knowing that listed providers are "quality assured" and recommended for care locally. Detailed information about referrals and authorizations is also included on this website, making provider selection easier and more convenient for beneficiaries.

Note: If you would not like your provider information published, please let your TOP Regional Network Contact know.
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