1199SEIU Benefit Funds - Claim submission address

Claims Submission

• Electronic claims, using Payer ID #13162:
(800) 845-6592

MD On-Line
(888) 499-5465

Capario (formerly MedAvant)
(800) 792-5256

We also accept both institutional and professional EDI claims from RelayHealth

• Paper claims, including request for claim review:
Medical Claims:
1199SEIU Benefit Funds

Medical Claims
PO Box 1007
New York, NY 10108-1007

Hospital Inpatient
Admissions; ER and

Ambulatory Surgery Claims:
1199SEIU Benefit Funds
PO Box 933
New York, NY 10108-0933

Dental Claims:
(not accepted electronically)
1199SEIU Benefit Funds
Dental Claims
PO Box 1149
New York, NY 10108-1149

The 1199SEIU Benefit Funds are among the largest self-administered, joint labor-managementfunds in the country. We are not an insurance company. We are a not-for-profit organization providing health and other benefits to 1199SEIU healthcare workers, retirees and their eligible
dependents covered by the 1199SEIU Benefit Funds – nearly 450,000 lives in total.

While the 1199SEIU Benefit Funds are jointly administered, it’s important to note that benefits and coverage vary between the 1199SEIU Benefit Funds. Employer contributions to the 1199SEIU Benefit Funds pay for the cost of benefits. The 1199SEIU Benefit Funds’ goal is to provide members with access to quality, cost-effective healthcare with few, if any, out-of-pocket costs.

This manual covers the benefits and services available to 1199SEIU members in the 1199SEIU   National Benefit Fund for Health and Human Service Employees, the 1199SEIU Greater New York Benefit Fund and the 1199SEIU National Benefit Fund for Home Care Employees. These Funds contract directly with you as a Member Choice or a Panel Provider. For more information, please visit our website at www.1199SEIUFunds.org.

Our 1199SEIU Home Health Aide Benefit Fund covers 1199SEIU members working as home health aides, who access care through the HIP, an EmblemHealth company. We encourage you to join this network if you do not participate already. To join HIP’s network, call (866) 447-9717, or visit their website at www.EmblemHealth.com.

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