Benefit Funds to Upgrade Our Claims Auditing Software
This upgrade to ClaimsXten will:
- Improve the accuracy of the Benefit Funds’ reimbursement coding policies;
- Provide enhanced technical functionality, thus reducing the need for manual reviews; and
- Assist with maintaining a consistent payment policy in alignment with CMS and industry standard billing guidelines.
You will continue to be responsible for billing with the most appropriate and valid CPT and/or HCPCS procedure codes, including applicable modifiers, for services that are consistent with the American Medical Association CPT manual and other similar publications. You will see edit reasons and explanations on your remittance notices when claims are not coded in accordance with the appropriate coding guidelines.
ClaimsXten: Information and Frequently Asked Questions
For more information, visit the Benefit Funds’ website in the coming weeks, contact your Provider Relations Representative or call our Provider Relations Call Center at (646) 473-7160.
More Provider Connections
ClaimsXten Select Frequently Asked Questions (FAQs)
ClaimsXten Select is a clinically based claims-editing software solution that advances claims-auditing capabilities and resolves limitations in the current ClaimCheck software. ClaimsXten Select offers clinical coding logic and rules-based claims management with the...
Your 1199SEIU Patients Are Covered for Certain Coronavirus and Antibody Tests
The Benefit Funds are covering diagnostic testing for the coronavirus, as well as antibody testing when medically necessary, for your 1199SEIU patients. The Funds will not cover employment-related tests, antibody tests when there was a previously confirmed COVID-19...
The Benefit Funds Have Your 1199SEIU Patients Covered During the COVID-19 Pandemic
During this COVID-19 pandemic, the Benefit Funds have worked to support the care that you, our valued partners, provide to your 1199SEIU patients by helping to ensure they can access the testing and medical care they need. The Funds are covering diagnostic testing for...
We Are Temporarily Covering Telehealth Services for Your 1199SEIU Patients
Effective March 18, 2020, we are covering telehealth services for your 1199SEIU patients in an effort to help everyone limit contact with others during the COVID-19 crisis. We will cover consults via phone, video and other virtual means for all eligible medical and...
Verify Your 1199SEIU Patients’ Eligibility and Claims Online
We know how important it is for our participating providers to have access to real-time information on their 1199SEIU patients’ claims status and eligibility for services. That’s why we offer a quick and convenient way for you to view this information online, through...
No Prescription or Referral Required for Annual Mammogram
At the Benefit Funds, we support the care you provide our 1199SEIU members by reminding them to stay current with their annual preventive screenings, including mammograms for women between ages 40 and 80. As you know, the procedure is a vital tool in helping to detect...