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  • 1199 Authorization Form

Get 1199 Authorization Form

Prior Authorization Request Form Fax this request form to 1199SEIU Benefit Funds Radiology Review at (877) 601-1199 (Please print clearly) Date request received: Date request submitted: Referring.

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More than 200,000 members of 1199SEIU have won comprehensive healthcare coverage — hospitalization, doctors' visits, dental and vision care, prescription drugs, etc. — with no or minimal out-of-pocket expenses for themselves and their families. In all, the benefit covers more than 450,000 lives.

We are a union of healthcare workers. We work in the homecare, hospital and nursing home industries, as well as pharmacies, freestanding clinics and other healthcare settings.

Medical and Hospital. Mental and Behavioral Health. Prescription. Dental. Vision/Hearing. ... funds-column-menu. For Your Benefit Magazine. Retired Members Bulletin. Healthy Living. Programs. Wellness Program. Member Assistance Program. Prenatal Program. Citizenship. Continuing Coverage. COBRA. Disability. Paid Family Leave.

1199SEIU currently represents workers at more than 100 facilities across the state. Members work in some of Florida's largest for-profit healthcare chains and academic institutions, including HCA (Hospital Corporation of America), Tenet, Consulate, Greystone and University of Miami Hospital.

1199 was founded in 1932 as a New York City drugstore workers' union. Today's 1199SEIU represents the spectrum of healthcare professions in five states and the District of Columbia.

More than 200,000 members of 1199SEIU have won comprehensive healthcare coverage — hospitalization, doctors' visits, dental and vision care, prescription drugs, etc. — with no or minimal out-of-pocket expenses for themselves and their families.

Tens of thousands of 1199SEIU hospital-based members work throughout the mega-health systems that include Mount Sinai, NYU Langone, Presbyterian, Northwell Health (formerly Northshore LIJ), and Montefiore. These include hospitals, ambulatory care centers, off-site provider-based clinics, and other settings.

CLAIMS SUBMISSION Submit the completed form by fax to (646) 473-7088, by email to MedicalRecon@1199Funds. org or by mail to 1199SEIU Benefit Funds, Medical Claims Reconsideration, PO Box 717, New York, NY 10108-0717.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232