Effective Jan. 1, 2025, the Southern Ute Indian Tribe 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. 

Auxiant will be the new TPA processing all medical claims incurred outside of the Southern Ute Health Center beginning Jan. 1, 2025. Auxiant has been in business since 1982 with over 30 years of Tribal Health Plan administration experience.  

You will receive your new ID card 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. 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. Please be aware that you will also be receiving a Coordination of Benefits letter from Auxiant in January to verify if you are enrolled in any other insurance coverage outside of this plan. It is important that you respond to this inquiry timely 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.