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About the Plan
Back to Frequently Asked Questions
1. Is there a specific geographic area I must live in to join the
Kelsey-Seybold Greater Houston Plan?
Yes, and it includes most of the Greater Houston-Galveston area. Specifically, the Kelsey-Seybold service area includes all zip codes in Harris, Fort Bend, or Montgomery counties as well as most zip codes throughout Brazoria, Galveston, Liberty, Walker, Grimes, San Jacinto, Chambers, Austin, and Waller counties. If you have a question about your eligibility for the plan, call the Shell Benefits Service Center at
1-800-30-SHELL (1-800-307-4355).
2. What if I am currently under treatment with a non-Kelsey-Seybold physician at the time I switch to the
Kelsey-Seybold Greater Houston Plan?
If you’re currently under treatment for a serious medical condition, or you’re in your second or third trimester of pregnancy with a non-Kelsey-Seybold physician, you should complete the Transition of Care Request Form no later than 30 days after the effective date of your coverage to continue seeing your non-Kelsey-Seybold provider.
Your request will be reviewed for medical necessity. If approved, you will be able to continue seeing your current provider for the amount of time specified on the approval. Your care will then be transitioned into Kelsey-Seybold to establish a relationship with a Kelsey-Seybold physician.
Download and print out a copy of the Transition of Care Request Form and other helpful documents here.
Completed forms should be returned
no later than 30 days after the effective date of your coverage to:
The
Kelsey-Seybold Greater Houston Plan
11511 Shadow Creek Parkway
Pearland, TX 77584
Attn: Kelsey UM
You will receive a letter from Kelsey-Seybold to confirm Transition of Care approval including authorization dates and additional instructions such as where to obtain lab tests and X-rays.
For behavioral health related services (mental health/substance abuse care), please see below.
3. If I am currently receiving behavioral health related services (mental health/substance abuse care), will I need to find a new provider if I enroll in the
Kelsey-Seybold Greater Houston Plan?
The
Kelsey-Seybold Greater Houston Plan offers behavioral health (mental health/substance abuse) benefits for covered services received from providers who participate in Cigna’s Behavioral Health network. To see if your current provider is participating in the network, contact Cigna directly through the Customer Service Line at
1-855-279-1509. If you find that you current provider is not participating in Cigna’s network, and you have concerns about changing providers, Transition of Care may be authorized for the current practitioner to complete treatment and/or prepare you to transition to a Cigna Behavioral Health network practitioner. Cigna will review each case on an individual basis. If your situation is approved for Transition of Care benefits, you will be able to continue seeing your current provider for a specified period until the safe transfer of care to a Cigna Behavioral Health provider can be arranged. Please call the Customer Service Line at
1-855-279-1509 or ask your healthcare professional to call on your behalf to initiate the Transition of Care process. You or your provider must call within the first 30 days of your enrollment in the
Kelsey-Seybold Greater Houston Plan.
4. Why should I choose the
Kelsey-Seybold Greater Houston Plan and Kelsey-Seybold Clinic for my medical care?
The
Kelsey-Seybold Greater Houston Plan offers you the high-quality doctors and care coordination that Kelsey-Seybold is known for. You’ll enjoy many conveniences, including 24/7 appointment scheduling, the reassurance of our After-Hours Nurse Hotline at
713-442-0000, the ability to email your doctor’s office and schedule appointments online, Saturday appointments at four regional locations, and the freedom to choose from
any of Kelsey-Seybold’s doctors for your care –
with no referral required.
