Emergencies while traveling
An accident, a cardiac event, appendicitis on a cruise. The hospital took payment before discharge and handed you a one-page receipt.
International claims recovery
You paid the hospital abroad. Your plan may still owe you.
A foreign invoice is not a claim. We turn an itemized bill from a hospital in Madrid, Bangkok or Guadalajara into a coded, converted, properly formatted claim your US insurer can actually adjudicate — and we carry it through appeal.
Factura detallada
Hospital · Madrid
Consulta de urgencias, nivel 4180,00 €
TC craneal sin contraste420,00 €
Sutura de herida en cuero cabelludo, 4 cm260,00 €
Narrative invoice · no procedure codes · no NPI · EUR · paid in full at discharge
What we do →
CMS-1500 · lines 24A–24J
Submitted to payer
99284Emergency dept visit, moderate complexity$198.00
70450CT head/brain without contrast$462.00
12002Simple repair, scalp, 2.6–7.5 cm$286.00
Dx S01.01XA laceration of scalp, initial encounter · converted at the date-of-service rate · records and proof of payment attached
Illustrative example. Real claims are built from your own records and your plan's requirements.
Who we help
People with US coverage who were treated outside the country
Planned treatment abroad
Surgery, oncology, orthopedics or specialty care you chose to receive overseas and paid for yourself. Non-cosmetic procedures only.
Expats and long-stay residents
You live overseas but still carry a US employer or marketplace plan, and no one at the hospital has ever filed to a US payer.
Students, missionaries and crew
Study-abroad programs, mission work and contract assignments where the local clinic bills in cash and local currency.
The real obstacle
Why foreign bills get denied, even on plans that cover the care
Most of these denials are not coverage decisions. They are processing failures. The plan would pay, but nothing arrived in a form the payer's system can read.
Codes
No CPT, HCPCS or ICD-10 on the bill
Foreign hospitals bill in their own language and their own format. US payers adjudicate line by line against code sets. A narrative invoice gives the adjudication engine nothing to price.
Provider
The provider has no NPI
Foreign physicians and facilities have no National Provider Identifier. Each payer handles non-US providers differently, and the claim has to be built the way that specific payer accepts.
Form
A receipt is not a claim form
Professional services belong on a CMS-1500 and facility charges on a UB-04. Uploading a PDF of the hospital's invoice to a member portal usually produces a denial for incomplete submission.
Currency
Amounts not converted or not documented
Charges have to be stated in US dollars at the exchange rate on the date of service, with the rate source documented. Converting at today's rate invites a reduced or rejected payment.
Records
Missing medical records or proof of payment
Payers want the itemized bill, the clinical record supporting medical necessity, and evidence that you personally paid. A discharge summary in another language needs translation to be usable.
Deadline
The timely filing window closed
Filing limits commonly run from 180 days to 12 months after the date of service and vary by plan. This is the one problem that cannot be fixed later, which is why the clock matters more than the paperwork.
Our process
Four stages, in order, with nothing owed up front
01
Benefits review, at no cost
We read the plan document itself, not the summary — the out-of-network provisions, the foreign and emergency care language, and the filing deadline. Then we tell you what is realistic before you commit to anything. If the plan genuinely will not pay, we say so and you owe nothing.
02
Document assembly and translation
We tell you exactly what to request from the foreign provider and draft that request in their language when needed. We handle translation of records and the currency conversion, documenting the date-of-service rate we used.
03
Coding and submission
Each service is coded to CPT or HCPCS with supporting ICD-10 diagnoses, assembled onto a CMS-1500 or UB-04, and filed to the payer the way that payer accepts claims from non-US providers.
04
Follow-through and appeals
We track the claim, answer payer requests for information, read every EOB, and appeal denials through first level, second level, and external review where your plan allows it. The insurer pays you directly. Only then do we invoice.
Intake checklist
What to gather before you call
Missing items are not a reason to wait. Bring what you have and we will help you get the rest, including from providers who have already closed your file.
- Itemized bill from the foreign providerEach service listed separately with its own charge. A lump-sum total is not enough.
- Medical records and discharge summaryWhat was done and why. This is what establishes medical necessity.
- Proof of payment in your nameCard statement, wire confirmation, or a stamped paid receipt.
- Your insurance card, front and backPlus the plan document or SPD if you can get it from HR.
- Dates you were out of the countryPassport stamps, boarding passes or an itinerary.
- Anything the insurer has already sent youDenials and EOBs tell us what the payer's system did with an earlier attempt.
Before you call
What we will not tell you
Three things we would rather say now than after you have spent time on an intake packet.
No guarantee
We do not promise reimbursement, and nobody honestly can. Coverage depends on your plan language, the care you received, and the payer's determination. What we control is whether the claim is built correctly and pursued properly.
Medicare
Medicare generally does not cover care received outside the United States, with narrow exceptions. If Medicare is your only coverage, we will tell you at the first call rather than open a case.
Out of scope
We do not work cosmetic procedures or routine dental care. Reconstructive surgery following injury or illness is a different matter and often worth reviewing.
Who is behind this
Twenty-four years of out-of-network claims, pointed at one problem
Med Bill Abroad is the international arm of American Medical Health Alliance, a family-run advocacy and billing practice operating since 2002. AMHA was built around patients who paid cash for care their insurer would not pay directly, and over time a particular kind of file kept arriving: a bill from a hospital in another country, already paid, with no one willing to help file it.
Those cases need something different from domestic out-of-network work. The documents arrive in another language and another billing convention. There is no NPI to put on the form. The exchange rate matters. The deadline is usually already running. That is a specialty, and it deserves its own practice.
Alex Lopera has worked these claims since 2002 and leads the team. Every case is handled in-house in Houston.
Questions we get
Straight answers
My insurer told me on the phone they don't cover anything overseas.
The plan document controls, not the representative. Many plans cover emergency care abroad, and a good number cover non-emergency out-of-network care at some level. Send us the plan and we will read the actual provisions. A phone denial is not a claim determination and cannot be appealed, which is part of why it is worth filing properly.
How long does this take?
Typically 30 to 90 days from submission to a first determination. Appeals add time, often several months. Assembling records from a foreign provider is usually the slowest part and depends on how quickly that hospital responds.
The hospital only gave me a one-page receipt.
Common, and fixable. We draft the request for a properly itemized bill and the clinical records, in the provider's language where that helps, and we follow up with their billing office. Most hospitals will produce it once someone asks correctly.
Is it too late?
It depends on your plan's timely filing limit, which commonly runs from 180 days to 12 months after the date of service. Some plans allow exceptions for good cause. Tell us the date of service and the carrier and we will check before you do anything else.
What does it cost?
A percentage of what we actually recover for you, agreed in writing before we start. If the claim is not paid, you owe us nothing. The benefits review before that is free.
Will this affect my ability to use my insurance later?
No. Filing a claim for care you received is the ordinary use of your coverage. A denied claim does not count against you, and pursuing an appeal is a right your plan is required to provide.
Free claim review
Tell us what happened and where
No cost, no obligation. We will tell you whether the claim is worth filing and what the deadline looks like.
If your filing deadline is close, call instead of writing. We can usually tell within one conversation whether a claim is still live.
Phone1-800-221-0817
Emailclaims@medbillabroad.com
Mail11807 Westheimer Rd, #550-158
Houston, TX 77077
Houston, TX 77077
HoursMonday–Friday, 9:00–5:00 Central