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Contact any of the three Tribal Health Benefits Coordinators for help with the transition to the Tribe's new Third-Party Administrator, Auxiant. Phyllis Rhodes and Lori Herrera are both Benefits Resources Specialists with the Tribe; Elizabeth Gallegos is the Tribe’s Referral Services Specialist. 
Members of the Southern Ute Tribal Council show off their recently issued Auxiant ID cards in an effort to get the word out to the Tribal community about the new changes to the Tribal member health benefits plan, which took effect Jan. 1, 2025.
Photo Credit: Jeremy Wade Shockley | The Southern Ute Drum
Photo Credit: Summer Begay | Tribal Council Affairs
Photo Credit: Robert L. Ortiz | The Southern Ute Drum
Photo Credit: Jeremy Wade Shockley | The Southern Ute Drum
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Benefits Coordinators provide faster and more accurate answers with Auxiant 


The Southern Ute Tribal member health benefit plan has contracted with a new Third-Party Administrator (TPA) and Pharmacy Benefit Manager (PBM) for improved technology, service, and medical and prescription drug claims processing; beginning Jan. 1, 2025, Auxiant will be the new TPA processing all medical claims incurred outside of the Southern Ute Health Center.  

Auxiant has been in business since 1982 with over 30 years of Tribal Health Plan administration experience. “Auxiant will be able to provide more hours for our customer service,” Tribal Health Director, Lizette Langefels said. “They will also be able to save the Tribe money by assisting us to lower healthcare costs with better healthcare partners.” 

Auxiant provides Tribal members and the Tribal Health department with resources such as claims examiner and claims customer services representatives. They also assist with coordinating other benefits Tribal members may have in place to ensure all benefits can be used to their maximum. 

“Working with Auxiant has helped our Benefits Coordinators provide faster and more accurate answers to Tribal members,” Langefels said. “Please look forward to visiting with Auxiant members on March 4, when they will be holding a meet and greet with Question-and-Answer sessions both at the Health Care Clinic and the Museum.” 

Members of the Southern Ute Tribal Council show off their recently issued Auxiant ID cards in an effort to get the word out to the Tribal community about the new changes to the Tribal member health benefits plan, which took effect Jan. 1, 2025.

Southern Ute Tribal members should have received their new ID cards in December. Please provide this card to all of your providers to ensure prompt receipt and processing of your medical and prescription drug claims. This applies to hospitals, clinics, physician offices, and retail pharmacies. A digital copy of your ID card will also be available on www.auxiant.com upon completing the member registration process for an online account or in the Auxiant Health mobile app which can be found in the App Store or Google Play on your smartphone. 

“We’re happy to help with Tribal member health benefits, our Health Benefits Coordinators are the right people to go to,” Langefels said. “If for any reason you did not receive a card in the mail mid-December, contact any of the three Tribal Health Benefits Coordinators.” Phyllis Rhodes and Lori Herrera are both Benefits Resources Specialists with the Tribe; Elizabeth Gallegos is the Tribe’s Referral Services Specialist. 

Patients are more than welcome to throw away old cards, the Southern Ute Health Center recommends that individuals use best practices to destroy or demark them prior to discarding.  

Tribal members will also be receiving a Coordination of Benefits letter from Auxiant in January to verify if they are enrolled in any other insurance coverage outside of this plan. It is important that you respond to this inquiry in a timely manner via mail, on www.auxiant.com under AuxiantHealth Correspondence tab, or by calling Auxiant at 800-475-2232.  

If you have any questions, please contact the Southern Ute Tribal Health Department.  

 

 

ADDITIONAL INFO: 

For any outstanding medical claims that have not been processed by your current TPA by Dec. 31, 2024, please have your provider re-submit these claims to Auxiant (PO Box 0392 Milwaukee, WI  53201-0392, Payer ID: 76079 or AUX01) for review and processing. For any questions on member eligibility/coverage verification, plan benefits, or claims status, you or your provider may also call Auxiant at 800-475-2232.  

ClearScript will be the new PBM processing all prescription drug claims provided outside of the Southern Ute Health Center Pharmacy beginning Jan. 1, 2025. ClearScript is a leading Pharmacy Benefit Manager with many years of experience supporting Tribal nations and Tribal members. ClearScript will be able to answer any questions surrounding your prescription drug coverage and help you achieve the best outcomes for your prescribed medications. Please visit https://www.clearscript.org/member or call Member Services at 888-807-7858.  

Please be sure to discard your current Medical and Prescription Drug ID card through Forest County Potawatomi Insurance Department and Silverback Rx on Jan. 1, 2025, and begin using your new ID card through Auxiant and ClearScript. 

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