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  • Enhancements to EviCore Streamline Prior Authorization Process

    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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  • COVID-19 Vaccine and Pregnancy

    COVID-19 Vaccine and Pregnancy

    COVID-19 Vaccine and Pregnancy

    Dr. Pernell and Dr. Salas-Lopez discuss the COVID-19 vaccine and pregnancy.

  • COVID-19 Vaccine and PPE

    COVID-19 Vaccine and PPE

    COVID-19 Vaccine and PPE

    Dr. Pernell and Dr. Salas-Lopez discuss PPE usage and the COVID-19.

  • COVID-19 Vaccine and Community Immunity

    COVID-19 Vaccine and Community Immunity

    COVID-19 Vaccine and Community Immunity

    Dr. Pernell and Dr. Salas-Lopez discuss reaching community immunity through the COVID-19 vaccine.

  • COVID-19 Vaccines and Efficacy

    COVID-19 Vaccines and Efficacy

    COVID-19 Vaccine and Efficacy

    Dr. Pernell and Dr. Salas-Lopez discuss the COVID-19 vaccine efficacy.

  • COVID-19 Vaccine and Children

    COVID-19 Vaccine and Children

    COVID-19 Vaccine and Children

    “If I recommend it for my family, I recommend it for your family.” Dr. Pernell and Dr. Salas-Lopez discuss the COVID-19 vaccine and children.

  • Fireside Chat with Dr. Pernell and Dr. Salas-Lopez

    Fireside Chat with Dr. Pernell and Dr. Salas-Lopez

    Fireside Chat with Dr. Pernell and Dr. Salas-Lopez

    Dr. Pernell and Dr. Salas-Lopez discuss the impact of COVID-19, the importance of the COVID-19 vaccine and address vaccine efficacy and concerns on side effects, fertility, children and much more.

  • MaryGrace Colobong: Member Profile

    MaryGrace Colobong: Member Profile

    MaryGrace Colobong

    After a trying year—both physically and emotionally—MaryGrace Colobong reflects on the peace of mind her 1199SEIU health benefits afforded her.

    When the COVID-19 pandemic began last year, MaryGrace Colobong had no idea how much her job as a Nursing Assistant at Cold Spring Hills Center for Nursing and Rehabilitation—as well as life for the residents there—was about to change. After becoming one of the first staff members to be infected with the virus, in March 2020, she kept a video diary of her experience. “I wanted to help other people know what it was like,” she explained. She detailed her symptoms, which included chills, difficulty breathing and a loss of smell and taste that lasted for over two months. As difficult as her recovery was, she is grateful she never had to worry about getting the care she needed, thanks to her 1199SEIU health benefits.

    Once MaryGrace did recover, she returned to work, which, she said, resembled “a war zone,” with staff having to wear “so much personal protective equipment, we looked like soldiers.” Sadly, she also lost seven residents who she felt were like members of her own family. Despite the risks, the pandemic reminded MaryGrace why she had chosen a career in the healthcare industry. “I feel like I’m making a difference in people’s lives,” she explained. With the facility in lockdown, she helped residents connect with their family members via video chat, and she was thrilled when family visits resumed in April 2021.

    My benefits are like a well-rounded support system, covering so many things that you can’t even predict you’ll need. That makes me feel very secure, knowing I have their support—especially in times like these!

    MaryGrace Colobong

    Nursing Assistant

    Cold Spring Hills Center for Nursing and Rehabilitation

    Now fully vaccinated, MaryGrace hopes others will follow her lead. “People know how bad having COVID-19 was for me,” she said, “so if they want to avoid what I went through, they may decide to get the shot, too.”

    Her bout with COVID-19 wasn’t the first time MaryGrace faced serious illness. Diagnosed with breast cancer in 2017, she relied on her 1199SEIU health coverage to receive her lifesaving treatment, and continues to get screened every six months. “I’m very lucky,” she said. “I don’t know how I could have paid for everything without my benefits.”

    As she looks forward to an eventual return to normalcy after the pandemic, MaryGrace reflects on how thankful she is for her Fund benefits. “They really are a must, especially in my field, where you can get sick at any time,” she said. “My benefits are like a well-rounded support system, covering so many things that you can’t even predict you’ll need. That makes me feel very secure, knowing I have their support—especially in times like these!”

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