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
Provider Notice/FAQs: Federal No Surprises Act
More Provider Connections
Enhancements to eviCore Streamline Prior Authorization Process
The 1199SEIU Benefit Funds are enhancing their partnership with the eviCore Healthcare Review Program to help ensure that your 1199SEIU patients receive the most consistent standard of cancer care. These changes, which will go into effect on October 1, include...
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...
Provider Notice/FAQ: COVID-19
In response to the COVID-19 pandemic, the Benefit Funds have temporarily changed certain policies to help ensure your 1199SEIU patients have access to medical services during the federal COVID-19 Public Health Emergency (PHE). Be sure to check the Funds website for...