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Aetna

​​​Frequently Asked Questions​

About Kelsey-Seybold Clinic and Aetna PPO, POS, and EPO​ Plans

Which Aetna plans pay in-network benefits for Kelsey-Seybold doctors and services?
Kelsey-Seybold Clinic will be back in-network for most Aetna products and health plans with the exception of Aetna HMO/HNO plans and some customized plans that require the use of specific physician and/or hospital networks. Kelsey-Seybold will be in-network for most PPO, POS, and EPO plans, including (but not limited to):
  • Aetna SelectSM
  • Open Access Select
  • Elect Choice®
  • Aetna Open Access® Elect Choice
  • Aetna Choice® POS II
  • Managed Choice®
  • Open Choice® PPO

KelseyCare Aetna, an established in-network health plan (since 2016), is our high-performance health plan, offered to employers in the greater Houston area alongside PPO, POS, and EPO plans.  (Also called Kelsey Select for active Teacher Retirement System (TRS) members with the State of Texas).

When will the Aetna PPO, POS, and EPO members have in-network access to Kelsey-Seybold Clinic?
Aetna PPO, POS, and EPO plan members will have access to Kelsey-Seybold Clinic as an in-network provider beginning July 1, 2018.

Are the Aetna broad HMO/HNO products part of this in-network agreement with Kelsey-Seybold? 
Aetna HMO/HNO plans are not part of the in-network agreement. The Aetna QPOS product is an HMO plan. Kelsey-Seybold participates in a high-performance narrow network plan with Aetna called, KelseyCare Aetna.  This plan is available to employers with two or more employees and delivers a lower total medical cost.  Employers looking to provide a product that requires selecting a primary care physician (PCP) and has access to Kelsey-Seybold should consider offering KelseyCare Aetna health plan.

Aetna offers a Medicare PPO plan. Is this part of the in-network agreement with Kelsey-Seybold?
​Kelsey-Seybold does not participate in any of the Medicare products offered by Aetna, including the following:  Aetna Medicare Plan (HMO), Aetna Medicare Open Access Plan (HMO), Aetna Medicare Prime Plan (HMO), Aetna Medicare Plan (PPO), and Aetna Medicare Prime Plan (PPO.)

Are there any other Aetna plans that are not part of the in-network agreement with Kelsey-Seybold?
Some employers offer customized plan designs that require the use of specific physician and/or hospital networks in order for benefits to be paid at in-network levels. All members should refer to their plan materials to determine if their employer is offering a customized network for physician or hospital services.    


Who can help me select a new PCP or specialty provider?
We encourage new patients to visit our website and view physician bios and their videos. Patients who would prefer to receive a recommendation for specific physicians in our more than 55 medical specialties can call the Patient Help Line to get personalized help choosing a physician and location at 713-442-1233. New patients can call our Pre-Enrollment Help Line at 713-442-1233 and a live operator can help you identify the physicians you may need on your care team.

Can I see a Kelsey-Seybold physician/specialist if I'm seeing specialists in the Aetna "Aexcel" network/plan?
If an employer offers the Aexcel network as an option, it is "part of their broad network offering." That means members can see any specialty care physician in the Broad network but may have lower co-pays to see a specialty care physician that has the "Aexcel" designation.  ​

Will I be able to use the labs/LabCorp facilities at Kelsey-Seybold Clinic locations now and remain in network?
Yes, if you get lab services inside a Kelsey-Seybold Clinic location, your lab testing will be considered in network. Your Kelsey-Seybold physician will electronically send your lab orders to a Kelsey-Seybold Clinic of your choice. 

It is important to note that if you use a standalone laboratory or a LabCorp facility that is not part of Kelsey-Seybold Clinic, your health plan may not cover the testing, or you might incur out-of-pocket charges. 

Where can I get my Mammograms/Radiology tests completed?
Your Kelsey-Seybold doctor can place your radiology order for your tests at a Kelsey-Seybold Clinic of your choice. This is a benefit to our patients as it is more efficient process, and allows for prompt management of your results by your physician and Radiology team and they will work in conjunction with our Breast Diagnostic Center if further testing is needed.  Your test results will also be available via your MyKelseyOnline account.

Your Radiology tests at Kelsey-Seybold are in network, so there are no added out-of-pocket costs for having your exam at Kelsey-Seybold; ​your normal coinsurance or deductible would apply. 

How can I transfer my medical records to Kelsey-Seybold?
You can download the Release of Information form, which is found on our website or here: https://www.kelsey-seybold.com/documents/release-of-information.pdf.  If you have any issues, you can also call our Medical Records department at 713-442-5700.  

Can I book an appointment now, or do I need to wait until July 1 to schedule?
You can schedule now!  Aetna health plan members in participating plans effective July 1 are welcome to call and schedule their appointments for July 1 or later by contacting our 24-hour Contact Center at 713-442-0000.

Can I use my old MyKelseyOnline account?

  1. If you have been a Kelsey-Seybold patient registered with MyKelseyOnline your account has remained active.  You will need to use the User ID and Password you set up previously to log in. 
  2. If you don't remember your log-in information, we first recommend you:
    1. ​Go to www.mykelseyonline.com
    2. Select "Forgot User Name" or "Forgot Password" on the right-hand side under the sign-in form, and follow the steps and prompts to reset your log-in information.
    3. ​If you are still unable to log-in, please contact: the MKO Help Line at 713-442-6565.  The help line is open Monday – Friday, 7a.m. – 9 p.m. and Saturday – Sunday, 7a.m. – 7 p.m.
  3. MyKelseyOnline and the MyChart App have great features/conveniences that allow you to schedule online, email with your doctor's office, eCheck-in at some locations, and more!  ​


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