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 agencies must submit the following EDI transactions through Change Healthcare:

• Professional and institutional claims: Payer-assigned payer ID 13162 – CPIDs 4551 (INST) and 5405 (PROF)
• Claims status: Real-time payer ID 1199NB
• Eligibility: Real-time payer ID 1199NB
• ERA: Payer-assigned payer ID 13162 – CPIDs 4551 (INST) and 5405 (PROF)

As of May 15, the Benefit Funds reject all EDI claims submitted directly to the Benefit Funds. If you do not have a clearinghouse or billing agency, or your current clearinghouse or service provider is unable to submit transactions through Change Healthcare, you may submit directly by connecting to Change Healthcare’s Connect Center portal.

If you have questions or encounter an issue during this transition, please contact Change Healthcare:

Please call the Benefit Funds at (646) 473-7160 for additional support.

More Provider Connections

Through our partnership with Healthix, the Benefit Funds have access to key health information about our members’ healthcare. This allows the Benefit Funds to identify health gaps and enable clinical outcome trend analysis for its “Healthy Living” initiative. Please ask your 1199SEIU patients to give their written consent to share their health information through Healthix. If you are not a partner of Healthix for health information exchange and are interested in joining or would like more information, call (877) 695-4749 or visit their website.

More Provider Connections

The Benefit Funds have partnered with WeightWatchers® to support members’ health journeys, including helping those with chronic conditions. According to WeightWatchers, its programs are proven to help those with diabetes control their blood sugar (measured by HbA1c) compared to standard care. If your patients need additional resources to support their health journeys, please encourage them to learn more about the Benefit Funds’ partnership with WeightWatchers by visiting www.1199SEIUBenefits.org/WW.

More Provider Connections

In April, the Benefit Funds launched access to Virta, a program with a medically based approach to reduce A1C levels and potentially even reverse type 2 diabetes without medications or surgery. Virta will be offered at no cost to eligible 1199SEIU members and their dependents who have A1C levels of seven or higher. The program includes a Virta app to log health data and symptoms, which Virta clinicians can then access to recommend treatment and any necessary adjustments in collaboration with members’ providers. It also features individualized nutrition therapy with carbohydrate restriction; health coaches; and tools to measure blood glucose, ketones and weight. Please encourage your eligible patients to create an account at www.VirtaHealth.com/join/1199 or to email Support@VirtaHealth.com for more information.

More Provider Connections