We are a Preferred Provider Organization, not an HMO or an insurance company. Our priority is ensuring quality care for 1199SEIU members and their families.
Not Accepting New Provider Applications
The Benefit Funds may deny participation requests if there is an adequate number of providers in a specialty who are already participating in specific geographic locations, or if there is a preferred vendor in the provider’s specialty. The Funds are accepting applications for providers that are members of an existing participating group.
The Benefit Funds are not currently contracting with new providers for the following specialties, unless there is a specific network need:
- Cardiovascular disease
- Chiropractic
- Dental (for National Benefit Fund members)
- Contact EmblemHealth’s dental provider network management services at [email protected], or visit the Dental Provider Resources section of EmblemHealth’s website, where you will find documents for participation.
- Ophthalmology
- Physical medicine and rehabilitation
- Physical therapy
- Podiatry
The Funds have preferred relationships with the vendors in the following specialties and are therefore not accepting new providers:
- Durable medical equipment (DME)
- Freestanding laboratory
- Freestanding radiology
- Home infusion
Applying for Participation
To apply to be on our panel of participating providers, complete the Provider Recruitment Form (see exclusions above under “Not Accepting New Provider Applications”) and mail, fax or email the completed form to:
Provider Relations Department
Network Management
498 Seventh Avenue
New York, NY 10018-0009
Fax: (646) 473-7213
Email: [email protected]
Providers must be affiliated with one of our participating hospital networks. To check if your hospital is in the network, search our directory.
If you are affiliated with a network hospital, complete the Provider Recruitment Form and email us at [email protected] or call our Provider Relations Call Center at (646) 473-7160.
Credentialing
The Benefit Funds have partnered with the Council for Affordable Quality Healthcare (CAQH). For more information, see our Recredentialing page.
Not Registered with CAQH?
Effective January 1, 2017, the Funds are requiring the CAQH application for participation into the Benefit Funds provider network. You can register at proview.caqh.org/PR/Registration.
