Affiliate Providers

Kelsey CareLink Login

Kelsey CareLink is a secure online portal offering referring physicians access to their patients' up-to-date electronic health records to track appointments, lab results, medications, verify eligibility, check claims status and more.

If you encounter errors when trying to review claim status from this screen, please call 713-442-4257.

• 2026 Utilization Management Authorization Request Form
• Utilization Management - Transition of Care/Continuity of Care Form
• Utilization Management - KelseyCare Advantage Prior Authorization list effective 1/08/2026
• Claim Submission Information
• Provider Reconsideration & Dispute Request Form – KelseyCare Advantage
• Provider Reconsideration & Dispute Request Form – Kelsey-Seybold Clinic

Claims Submission Information

All claims for authorized, covered services provided to eligible, Kelsey-Seybold assigned HMO, POS and EPO members must be submitted on a CMS 1500 form, a UB 04, or in an electronic format, as applicable. Claims submitted with ‘Unlisted Procedure Codes’ must include documentation supporting the use of that code for payment consideration. If necessary to determine if the claim is payable, Kelsey-Seybold may within thirty (30) days of receipt of a clean claim, request additional information from the treating provider.
For update to date claim filing directions please visit National Uniform Claim Committee - 1500 Instructions (nucc.org)

CLAIMS / DISPUTES / APPEALS / REFUNDS

Kelsey-Seybold Clinic has a standardized process for receiving radiology and laboratory orders from non-Kelsey physicians participating in capitated health plans (generally identified by “KelseyCare”, Capitated or Marketplace in the plan name. You can also refer to the Managed Care Resource Guide.)

To ensure a timely and seamless experience for patients and plan members, please submit orders via the appropriate fax/e-fax, or email addresses listed below.

When orders are faxed to Kelsey-Seybold, they are entered directly into the electronic medical record (EMR) system. Submitting orders via fax or e-fax helps ensure they are processed and available in advance, allowing for faster service when the patient arrives at a Kelsey location.

What should my patient do next?

• Patients can visit any Kelsey-Seybold location for laboratory or radiology services.
• Note: Some radiology services require a scheduled appointment—refer to the radiology order form for details
• Upon arrival, patients will be directed to the appropriate check-in desk.
• Patients will be responsible for paying any applicable cost-share
• After check-in, they will proceed to the Lab/Radiology waiting area until called for their service

What if orders weren’t sent electronically?

• Patients whose orders have not been submitted electronically may experience longer wait times upon arrival.
• If a patient brings only paper orders and they have not been sent ahead electronically, Kelsey-Seybold must complete an internal processing step.
• This process typically takes 15–30 minutes, which may delay service.

How does our office view the results?

• Results are automatically faxed to the affiliate provider’s default number on file in Epic, with an additional copy sent to the fax number listed on the requisition.
• Results can be accessed in Epic through Care Everywhere.
• When a Kelsey PCP places the order, they have the option to CC the affiliate provider on the results at the time of ordering.

Become An Affiliate Provider

If you are interested in becoming a contracted provider with Kelsey-Seybold Clinic please submit a Letter of Interest (LOI) by completing this form.

Or submit an LOI and include the following information:

• A company overview
• Services provided
• Your location(s)
• Geographical coverage areas
• Specialty services
• Medical staff roster, if applicable.

Submit LOI's to:

Kelsey-Seybold Clinic / PGT Provider Manual (update August 2025)

• KelseyCare Advantage Prior Authorization list effective 4/18/2025
• KelseyCare Advantage Prior Authorization list effective 3/3/2025
• KelseyCare Advantage Prior Authorization list effective 1/15/2025
• KelseyCare Advantage Prior Authorization list effective 4/8/2024
• Kelsey Care Advantage Prior Authorization list effective 1/1/2024