No Prescription or Referral Required for Annual Mammogram

At the Benefit Funds, we support the care you provide our 1199SEIU members by reminding them to stay current with their annual preventive screenings, including mammograms for women between ages 40 and 80. As you know, the procedure is a vital tool in helping to detect cancer at an early stage, when it is most treatable, leading to less aggressive treatment and higher rates of survival. To help ensure our members’ access to this potentially lifesaving procedure, we remind you that your 1199SEIU patients do not need a prescription or referral to schedule a mammogram. They simply need to provide their radiologist with the name and contact information of their primary care physician who will receive the test results.

If you have any questions, please call our Provider Hotline at (646) 473-7160.

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 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...