Most Claims Operations Restored after Cyberattack on Change Healthcare

Attention: The February 21, 2024, cyberattack on Change Healthcare disrupted the Benefit Funds’ and providers’ claims submission and reimbursement processes. The Benefit Funds have now fully restored most of our claims operations and are able to receive claims and issue payments through our partnerships with ABILITY and Zelis.

For now, the Benefit Funds are not issuing electronic payments. All payments are being issued via paper check, along with a paper remittance advice. While this solution allows us to continue fulfilling our payment obligations, we understand the inconvenience it may cause and are working to resume processing electronic payments as soon as possible.

Eligibility Verification

NaviNet's online provider portal

For customer support, including registration and technical assistance, please contact NaviNet directly at (888) 482-8057 or the 1199SEIU Interactive Voice Response system at (888) 819-1199.

Claims Submission

ABILITY (Inovalon) Help Center

Check Eligibility, Benefit and Claim Status Information with Self-Service Options

The Funds Provider Relations Call Center is currently experiencing higher than normal call volumes, and you may have to wait longer than usual to reach a Representative. The Funds have many self-service options to support you. To check 1199SEIU patient eligibility, benefit and claim status information, please visit our provider portal at www.NaviNet.net, or call (888) 819-1199 to be connected to our 24-hour automated claims and eligibility system. You can also email us at [email protected].

Telehealth Services Continue to Be Covered

Notice to 1199SEIU Providers and Hospitals: Coverage of Telehealth Services Made Permanent

We will continue to cover telehealth services for your 1199SEIU patients. This includes visits via phone, video and other virtual means for all eligible medical and mental health services, including COVID-19 related services. Please note: Effective October 15, 2021, the Benefit Funds no longer covers telehealth services provided by an urgent care center and will deny any claims with telehealth procedure codes or modifiers where the place of service is 20.

During the Public Health Emergency, the Benefit Funds covered all codes with a telehealth modifier of 95 or GT, or place of service code 02. Effective 05/12/2023, coverage determination will be made based on the Benefit Funds’ telehealth policy.