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 biosimilar first policy, medical oncology radiology imaging bundling and supportive drugs clinical review. In addition, they will help simplify the prior authorization process for cancer treatment services. For more information, please visit the Medical Oncology Review Program web page.

Funds Launch Updated Provider Directory

The Benefit Funds have introduced a new online provider directory platform with an enhanced user interface. We encourage you to review your office information and report any discrepancies by completing the Provider Demographic Information Change Request Form located on the Forms and Resources for Providers page.

Important Reminders

  • To help ensure that your 1199SEIU patients receive quality care, every three years the Benefit Funds recredential all applicable healthcare providers who participate in our provider network. Please respond to any requests for recredentialing and follow all instructions to avoid disruption in your network participation status.
  • Our Provider Relations Department is offering virtual education visits to review policies and/or answer questions. Please contact your Provider Relations representative to schedule a session.
  • The Benefit Funds’ Preferred Drug List (PDL) and the Medical Plan PDL administered by Care Continuum are updated periodically. Please check the PDL page on the Funds’ website for the latest information.

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