The third party administrator (TPA) that the State employs to pay your healthcare bills is AETNA. This change was effective as of January 1, 2014. Your medical bills are administered in accordance with AETNA’s policies and procedures

You need to pre-certify for many of the medical procedures. Under AETNA there are 26 procedures that require pre-certification. Your provider is required to accomplish the pre-certifications if he/she/they are “in-network”. If the provider is not in-network, you will have to do the pre-certification and if you have the procedure done out of network, the amount that will be paid by Select Benefits will be a lesser amount. You should make sure your provider is a members of the AETNA network. If you have a procedure scheduled make sure that you have pre-certified. The penalty for not pre-certifying can be very costly.