Archive
Ensure Your Provider Directory Demographic Information Is Current
Under the federal No Surprises Act (NSA), providers are required to ensure that their demographic information in provider directories is accurate. If you have any updates to your demographic information, such as changes in service locations, billing information, phone...
Photographs of Providers Added to Provider Directory
Patients who search provider directories often like to see photographs of healthcare providers, in addition to information such as names, specialties and locations. In response, the Benefit Funds have begun uploading photographs to our online provider directory. If...
Verify Your 1199SEIU Patients’ Eligibility and Check Their Claims Online
We know how important it is for providers to have access to real-time information on their 1199SEIU patients’ claims status and eligibility for services. That’s why we offer a quick and convenient way for you to view this information online, through NaviNet, the...
Updates to Claims Auditing Software
In the coming months, the 1199SEIU Benefit Funds’ ClaimsXten Select Claims auditing software system will be updated to include Medically Unlikely Edits (MUEs), which prevent payment for an inappropriate number/quantity of the same service on a single day. An MUE for...
Provider Notice/FAQs: Federal No Surprises Act
More Provider Connections
Benefit Funds to Upgrade Our Claims Auditing Software
Effective March 1, the Benefit Funds will upgrade our claims-auditing platform, from ClaimCheck to ClaimsXten, to meet our needs for a more comprehensive and well-known solution that is used by many payers to adjudicate applicable claims according to prevailing...
Coming Soon to eviCore Medical Oncology
Enhancements Coming October 1, 2021 New cancer treatments are entering the market at an unprecedented pace. Since 2018, the U.S. Food and Drug Administration (FDA) has approved more than 136 new cancer indicators, including 53 novel cancer drug entities. The FDA has...
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...
The Benefit Funds Have Your 1199SEIU Patients Covered During the COVID-19 Pandemic
During this COVID-19 pandemic, the Benefit Funds have worked to support the care that you, our valued partners, provide to your 1199SEIU patients by helping to ensure they can access the testing and medical care they need. The Funds are covering diagnostic testing for...
Your 1199SEIU Patients Are Covered for Certain Coronavirus and Antibody Tests
The Benefit Funds are covering diagnostic testing for the coronavirus, as well as antibody testing when medically necessary, for your 1199SEIU patients. The Funds will not cover employment-related tests, antibody tests when there was a previously confirmed COVID-19...