FAQ | Blue Essentials with Kelsey-Seybold Doctors | Kelsey-Seybold Clinic (2024)

As a member of the Blue Essentials Plan with Kelsey-Seybold Doctors do I need to get a referral to see a Kelsey-Seybold specialist?

No, you can schedule an appointment directly with any Kelsey-Seybold specialist at any Kelsey-Seybold location, no referrals required. Kelsey-Seybold’s doctors have expertise in more than 65 medical specialties.

As a Blue Essentials Plan with Kelsey-Seybold Doctors member, you also have access to an extensive network of credentialed, contracted specialists with a referral from your Kelsey-Seybold physician. Affiliate specialists include doctors from Texas Children’s Hospital, Baylor College of Medicine, and other highly regarded Kelsey-Seybold physician organizations.

What if I need emergency care?

• Go to the closest emergency room if you are experiencing a serious medical emergency that requires immediate medical attention. If a situation seems life-threatening, take immediate action, and call 911.
• Emergency services are a covered benefit, but may vary by plan. Contact Blue Cross Blue Shield at the phone number shown on your member ID card or refer to your Summary of Benefits and Coverage (SBC) for details.
• Emergency care services include medical, psychiatric, surgical, hospital, and related healthcare services, such as ambulance service and testing, which are required to treat a sudden, unexpected onset of bodily injury or serious sickness. Examples of emergency situations include uncontrolled bleeding, seizures or loss of consciousness, shortness of breath, chest pains, or severe squeezing sensations in the chest, suspected overdose of medication or poisoning, sudden paralysis, or slurred speech.

Is there a specific geographic area I must live in to enroll in the Blue Essentials Plan with Kelsey-Seybold Doctors?

Who should I contact if I have Blue Essentials Plan with Kelsey-Seybold Doctors medical benefits and claims questions?

• Direct benefit and claim questions to Blue Essentials Plan with Kelsey-Seybold Doctors Member Services at the phone number shown on your member ID card.
• Call the Kelsey Concierge at 713-442-8977, Monday – Friday, 8 a.m. to 5 p.m. Your Kelsey Concierge provides personalized assistance to answer your questions and help resolve any concerns you may have.

Will I continue to have access to Blue Essentials Plan with Kelsey-Seybold Doctors 24/7 Health Information Line to speak with a nurse when needed?

• Yes, you will continue to have access to Blue Essentials Plan with Kelsey-Seybold Doctors Health Information Line. Call the member or customer service phone number shown on the back of your member ID card.
• As a Blue Essentials Plan with Kelsey-Seybold Doctors member, you also have access to Kelsey-Seybold’s After-Hours Nurse Hotline by calling 713-442-0000. The After-Hours Nurse Hotline is staffed by Kelsey-Seybold registered nurses who can access your secure electronic medical record and page your Kelsey-Seybold physician when needed. You can call the After-Hours Nurse Hotline after 5 p.m. on weeknights and anytime on weekends and holidays to ask questions or discuss concerns regarding symptoms or illnesses you or a family member may be experiencing.

Will I continue to have access to member resources on BCBS.com?

Will my healthcare providers file my claims with Blue Cross Blue Shield or with Kelsey-Seybold?

What if I become ill or injured while I'm traveling outside of the Houston area?

• When you or a covered family member need to see a doctor, you have access to Blue Cross Blue Shield’s nationwide, in-network urgent care centers. Contact Blue Cross Blue Shield at the phone number shown on your member ID card for more information about participating urgent care clinics.
• Blue Cross Blue Shield in-network urgent care clinics are a covered benefit.
• Benefits may vary by plan. Please refer to your Summary of Benefits and Coverage (SBC) for details.
• As a Blue Essentials Plan with Kelsey-Seybold Doctors member, you have access to virtual care on weekdays, weekends, and holidays.
  
  • VideoVisitNOW (co-pays apply) provides on-demand care for adults (ages 18+) from 7 a.m. to 9 p.m., Monday – Friday and 10 a.m. to 9 p.m. on weekends and holidays. You can also schedule on-demand Video Visits for children (0 – 17 years) from 5 p.m. to 8 p.m., Monday – Friday. Wait times average 20 minutes or less!
  • Scheduled Video Visits (co-pays apply) provide primary care and specialty care for adults 18+ and children 0 – 17 years old from 8 a.m. to 5 p.m., Monday – Friday. Video Visits for primary care only are available on Saturdays from 9 a.m. to 2 p.m.
• If you need a prescription filled while traveling outside of the Houston area, your Kelsey-Seybold physician can order the prescription for you. To refill a prescription:
  
  • Send a secure message through MyKelseyOnline or the MyKelsey App to your doctor’s office.
  • Call 713.442.0000 and ask to be connected to your physician’s nurse.
  • If you have your prescription bottle you can call the pharmacy phone number on the bottle and request that they transfer your prescription to a pharmacy close to you.

Depending on the severity of your situation:

• Go to the closest emergency room for serious and immediate medical treatment needs.
• Contact your Kelsey-Seybold physician during normal business hours.
• Contact the Kelsey-Seybold After-Hours Nurse Hotline at 713-442-0000. Kelsey-Seybold After-Hours registered nurses have access to your Kelsey-Seybold electronic medical record and can counsel you on appropriate care and next steps. The nurse can page your Kelsey-Seybold physician and have medications called into a local pharmacy, as necessary, to treat your condition.
• Seek care from one of Blue Cross Blue Shield’s nationwide, in-network urgent care centers.

What if I switch to the Blue Essentials Plan with Kelsey-Seybold Doctors while currently receiving care from a non-participating physician?

How is maternity coverage handled?

• Please refer to your Summary of Benefits and Coverage (SBC) for detailed information on maternity coverage.
• Take advantage of Kelsey-Seybold’s complimentary educational maternity classes and programs.
  
  • Learn more about the Kelsey-Seybold Pregnancy Portal.
  • Join a virtual breastfeeding class, available monthly at no cost.

Do I have access to urgent care clinics?

Yes, you'll have access to Blue Cross Blue Shield’s National Urgent Care Network through your Blue Essentials Plan with Kelsey-Seybold Doctors, as well as many options for after-hours care at Kelsey-Seybold. Saturday sick-care appointments at four Kelsey-Seybold regional locations: Bay Area Campus in Webster, Fort Bend Campus in Sugar Land, Memorial Villages Campus at I-10 and Katy Freeway, and North Houston Campus off FM 1960 and Cypress Woods Medical Drive. With the , you have many options for after-hours care, including:

• Kelsey-Seybold’s After-Hours Nurse Hotline at 713-442-0000 is available weeknights after 5 p.m. and on weekends and holidays. A Kelsey-Seybold registered nurse will answer your questions, page your Kelsey-Seybold physician if necessary, and schedule needed appointments. If a situation appears life threatening, take immediate action and call 911.
• Saturday sick-care appointmentsfor children and adults are available from 9 a.m. to 2 p.m. at four Kelsey-Seybold locations: Bay Area Campus in Webster, Fort Bend Campus in Sugar Land, Memorial Villages Campus on I-10/Katy Freeway and Bunker Hill, and North Houston Campus off FM 1960 and Cypress Woods. Call our 24-hour Contact Center at 713-442-0000 after 5 p.m. on Friday or on Saturday morning for a Saturday appointment.
• Urgent care is available through Blue Cross Blue Shield at urgent care clinics nationwide. You can find an urgent care clinic near you by searching the Find a Doctor tool via Blue Cross Blue Shield’s National Urgent Care. Urgent care clinics treat conditions that need immediate attention but aren’t life-threatening, such as broken bones, fractures, cuts, lacerations, sprains, strains, fevers, and minor infections.

How do I find out which hospitals are in the Blue Essentials Plan with Kelsey-Seybold Doctors network?

What happens if I need to see a specialist as a Blue Essentials Plan with Kelsey-Seybold Doctors member?

Kelsey-Seybold has specialists with expertise in more than 65 medical specialties. No referral is necessary to schedule an appointment with any Kelsey-Seybold specialist at any Kelsey-Seybold location. Go to kelsey-seybold.com/bios and search “Find a Doctor” by specialty to view biographies and Kelsey-Seybold physician videos.

When needed, your Kelsey-Seybold physicians will engage specialists on your behalf at Kelsey-Seybold and other top medical groups and hospitals to ensure a quality treatment plan to meet your specific care needs.

In addition, your Blue Essentials Plan with Kelsey-Seybold Doctors gives you access to an extensive network of affiliated specialists in the Texas Medical Center and in the community, and your Kelsey-Seybold physician will make a referral based on your needs. Affiliated specialists who work with us include doctors at the renowned Texas Children’s Hospital, Texas Heart Institute, Baylor College of Medicine, and other highly regarded Kelsey-Seybold physician organizations.

What happens if I need cancer treatment as a Blue Essentials Plan with Kelsey-Seybold Doctors member?

As a Blue Essentials Plan with Kelsey-Seybold Doctors member, you have access to our nationally accredited Cancer Centers, which deliver quality care from a team of medical experts that follow the most current national cancer treatment protocols. What our patients also get is highly personalized care.

Our goal is to personally guide our patients toward their triumph over cancer by delivering comprehensive, personalized care by cancer experts with access to today’s leading technology, including Varian Edge radiation technology. The Kelsey-Seybold Cancer Center at our Berthelsen Main Campus was the first in Houston to offer cancer treatment using the Varian Edge. The Varian Edge makes it possible to treat a wide range of cancers noninvasively, including cancers of the brain and spine – without anesthesia or surgery. It’s an important alternative to invasive surgery for tumors that are close to critical organs and are subject to movement in the body during radiation therapy.

Should you require care that’s not available within Kelsey-Seybold’s nationally accredited Cancer Centers and Infusion Centers, our cancer specialists will make a referral with the appropriate cancer center or treatment program that offers the best outcomes for your personal situation. This includes Baylor College of Medicine, MD Anderson Cancer Center, St. Luke’s Health, and Texas Children’s Hospital.

How can I communicate with Kelsey-Seybold online?

• With MyKelseyOnline.com and the MyKelsey app, you have a private and secure way to connect with your Kelsey-Seybold physicians and to keep track of test results, appointments, medical history, and more.
• Sign up at MyKelseyOnline.comor call 713-442-6565 for help with setting up or using your account. With MyKelseyOnline.com, you can:
  
  • Email your doctor's office.
  • Request prescription refills at your Kelsey Pharmacy.
  • View most test results.
  • Make your own appointments with Kelsey-Seybold primary care physicians and an expanding list of specialists.
  • Schedule on-demand virtual care and appointments for other medical services, including flu shots and other vaccines/injections and lab services.
• Our LanguageLine interpretation service for video visits is available for all Kelsey-Seybold video visits. This feature is taking the telemedicine experience to a new level by providing on-demand interpretation for our diverse patient population within seconds. In addition to English, there are currently six languages available for Video Visits: Arabic, Mandarin, Russian, American Sign Language, Spanish, and Vietnamese. Requesting a LanguageLine interpreter is a quick and easy process.

What’s included in the Blue Essentials Plan with Kelsey-Seybold Doctors?

Complete Access to Care, 24/7 – Choose the Kelsey-Seybold physician you want to see at any of our 40+ clinic and campus locations, and make an appointment with no referral required. Contact our 24/7 Contact Center for appointment scheduling. Speak to a Kelsey-Seybold registered nurse whenever you have a concern after hours – just call our After-Hours Nurse Hotline after 5 p.m. on weekdays and on weekends and holidays at 713-442-0000. Make appointments for sick care at four locations on Saturdays: our Memorial Villages Campus, Fort Bend Campus, Bay Area Campus, and North Houston Campus.

Access to Houston’s Top Hospitals – This includes facilities with Texas Children’s Hospital, St. Luke’s Health, Memorial Hermann, Houston Methodist, The Woman’s Hospital of Texas, and HCA Houston Healthcare.

All in One Place – Discover the convenience of having primary and specialty care, on-site labs, diagnostic services, and more all in one location. Plus, our regional campus locations bring outpatient surgery and nationally accredited cancer care even closer to home.

Secure Online Access to Your Kelsey-Seybold Physician – Enroll in MyKelseyOnline and download the free MyKelsey App to securely view your lab results and email your Kelsey-Seybold physician’s office with questions and follow-ups.

Your Care Team Is Connected – Your Kelsey-Seybold doctors are connected to each other and to you through your electronic health record. By working together, your care team provides the personalized care you need, plus a more streamlined healthcare experience.

Kelsey Concierge – Your Kelsey Concierge is your personal connection for answers, billing help, and more! Call 713-442-8977, Monday – Friday, 8 a.m. to 5 p.m.

Where can I get a prescription filled?

Why should I choose the Blue Essentials Plan with Kelsey-Seybold Doctors for my medical care?

IMPORTANT CONTACTS

Kelsey-Seybold Contact Center: 713-442-0000

• Available 24 hours a day, seven days a week to schedule appointments.

Kelsey-Seybold After-Hours Nurse Hotline: 713-442-0000

• Speak with a Kelsey-Seybold registered nurse after 5 p.m. on weeknights and on holidays and weekends.

Kelsey Concierge Service: 713-442-8977

• Speak with a concierge representative for expert help resolving your questions and concerns about your plan.

MyKelseyOnline: 713-442-6565

• Call 7 a.m. to 9 p.m., Sunday – Saturday, for help setting up or using your MyKelseyOnline account.