Tuesday, November 4, 2014

AETNA Wellsystems TRS Provider Coverage Issue



Important information regarding your TRS Active Care Medical Coverage
It has come to our attention that Aetna Wellsystems, the TRS-selected provider for our medical coverage, is experiencing internal electronic file issues which Aetna is working to correct. 
While we do not think the problem is widespread, the issue can create a discrepancy with how medical coverage is showing for a covered individual.  In other words, when you go to the doctor he/she may not think you have coverage even when you do.
SBISD has no way of knowing in advance which employees may be affected by this Aetna problem. 
ACTION: SBISD employees may want to contact their doctor’s office a few days before a scheduled appointment and have the office verify that coverage is showing for the employee. 
IF coverage is showing correctly, no further action is needed.
IF coverage is showing incorrectly, please contact the SBISD Benefits Department ASAP so we can work with Aetna to correct the problem prior to your appointment.
IF you have paid for a doctor’s visit or prescription out of pocket due to being told you do not have coverage, please let us know so we can provide you with an Aetna Reimbursement Request Form.
Aetna Wellsystems has assured SBISD that they are working as quickly as possible to correct the problem.  We have expressed our concerns about these problems and have told Aetna we expect them to be fixed ASAP.

SBISD Benefits Department
713-464-1511

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