1199 SEIU Benefit Funds

Prescribers CareContinuum™ pre-certification and authorization process

The 1199SEIU Benefit Funds uses CareContinuum™, an Express Scripts company to coordinate prior authorizations for certain medical drugs that providers may buy and bill the Benefit Funds for reimbursement.

For your patients who are covered under 1199 SEIU Benefit Funds medical benefits, prescribers and providers are required to contact CareContinuum™ to receive a prior authorization for certain prescriptions before administering the specialty drug to your patients.

View the CareContinuum™ 1199 SEIU Drug List

View the Specialty Pharmacy 1199 SEIU Drug List

 

Historical Drug List (One Year Prior)

How to complete and send a 1199 SEIU Prior Authorization

Use the ExpressPAth Provider Portal

Effective April 1, 2015, the 1199SEIU Benefit Funds require that all drugs necessitating prior authorization through the medical benefit be preauthorized using the web-based ExpressPAth Provider Portal.

As a prescriber or representative of a prescriber, you can now request prior authorization (PA) decisions for prescriptions online via CareContinuum’s ExpessPAth Portal. You can:

  • Submit new requests for prior authorization
  • Check on the status of submitted requests
  • Submit an authorization renewal or appeal on a previously submitted request

If you don't already have an account, download the ExpressPAth Quick Start Guide and create a free account today.

If you're unable to complete your submission online, you can use the CareContinuum™ Prior Authorization, and fax to (866) 343-1880 or call (877) 273-2122 for assistance.