At-home Colon Cancer Screening Test Covered for 1199SEIU Patients
In an effort to raise the colon cancer screening rates of our members, the Benefit Funds now provide coverage for the Cologuard Collection Kit. As you know, early detection is key to successfully treating colon cancer, and our members have screening rates below the national average. Cologuard is an easy-to-use, at-home screening method that requires no special preparation, dietary restrictions or medication changes. We encourage you to discuss this new alternative with your 1199SEIU patients for whom it may be appropriate. We understand that Cologuard may not be the right option for all patients, including those at high risk of developing colon cancer. Please note that we require prior authorization before prescribing the Cologuard test. For more information about the Cologuard Collection Kit, please visit www.CologuardTest.com.
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Provider Notice: Update to COVID-19 Benefits
During the federal COVID-19 public health emergency (PHE), the Benefit Funds temporarily changed specific policies to ensure that your 1199SEIU patients had access to medical services during that challenging time. Following the recent expiration of the PHE declaration...
Ensure Faster Claims Processing by Using Correct Billing Codes
The National Correct Coding Initiative (NCCI), which promotes national correct coding methodologies and controls improper coding and incorrect payments for medical services, includes three types of edits: NCCI Procedure-to-Procedure Edits prevent inappropriate payment...
ClaimsXTen Select Is Now Lyric
The Benefit Funds’ claims auditing software ClaimsXten Select is now Lyric. Only the name—not the software—has changed. Lyric will continue to assess the appropriateness of professional and outpatient hospital claims against clinically based coding rules and edits,...
The Benefit Funds Credentialing Committee Seeks Board-certified Physicians
The Benefit Funds invite all board-certified participating providers with exemplary credentials and leadership qualities to join the 1199SEIU Benefit Funds Credentialing Committee. As a committee member, you would help ensure that the Benefit Funds maintain a...
The Benefit Funds Are Recredentialing Our Provider Network
The Benefit Funds are recredentialing our provider network and need your help to ensure that members have access to quality in-network healthcare providers. Please update your Council for Affordable Quality Healthcare (CAQH) application and your attestation form. You...
Change Healthcare Is the Benefit Funds’ Exclusive EDI Partner Effective May 15
The Benefit Funds previously shared information about consolidating Electronic Data Interchange (EDI) clearinghouses into a single gateway through our partnership with Change Healthcare. This consolidation became effective May 15. All clearinghouses and billing...