Benefit Funds Expand Partnership with eviCore to Include Clinical Trial Management, Effective January 1, 2023
Beginning January 1, 2023, eviCore’s standard Clinical Trial Management Program will be available to support Benefit Funds members’ access to applicable outpatient clinical trials for all cancer types, as applicable. The program includes expert clinical trial case reviews by eviCore Medical Directors to identify reimbursable standard of care drugs and advanced imaging to improve the provider experience and optimize treatment options. For more information, visit the Benefit Funds’ Medical Review Programs Medical Oncology Services web page in the coming weeks, contact your Provider Relations Representative or call our Provider Relations Call Center at (646) 473-7160.
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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...
Important Alerts and Reminders
Aetna Choice POS II has been the wraparound network supplementing the Benefit Funds’ directly contracted network for coverage outside New York City since March 2, 2023. Aetna Choice POS II New York City provider locations are considered nonparticipating. Members must...