Funds’ Partnership with eviCore healthcare Can Help Reduce Disparities
To help ensure your 1199SEIU patients receive the highest, most consistent standard of cancer care, the 1199SEIU Benefit Funds partnered with eviCore healthcare. Using established, evidence-based clinical pathways, eviCore supports clinicians in pursuing the most effective course of action for medical oncology treatment by reviewing pre-service elective radiation therapy and medical oncology services, as well as outpatient high-tech radiology and nuclear cardiology studies. This process helps maintain consistency in diagnoses and treatment methodology and reduce disparities in treatment and outcomes for 1199SEIU cancer patients. The partnership between the Benefit Funds and eviCore, as well as the prior authorization process, can limit patients’ exposure to potentially harmful radiation treatments and encourage a more holistic and patient-centered approach to healthcare delivery.
More Provider Connections
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...