- Request for Part D Coverage Determination
- Request for Redetermination of Medicare Prescription Drug Denial
- Member Reimbursement Form
- Member Part D Reimbursement Form
- Elderplan Provider Manual
- SNP Model of Care
- Federal Deficit Reduction Act Policy
- Sunrise Laboratories Patient Services Centers
- Bioreference Laboratories
- Shiel Labs
- Provider Non-Interference Reminder
- Clinical Practice Guidelines
- ISNP Guidelines
- No Balance Billing Medicare QMB Members Notice
- No Balance Billing Medicaid Members Notice
- Replacement Claims Submission
- EFT Communications
- Elderplan Advantage for Nursing Home Residents Telehealth Overview
- Physician's Order Form for CDPAS
- Part B Step Therapy List 2022
- Part B Step Therapy List 2023
- Non-Preferred Part B Drug Request Form: Nyvepria, Ziextenzo
- Non-Preferred Part B Drug Request Form: Granix, Leukine, Neupogen, Nivestym
- Non-Preferred Part B Drug Request Form: Herzuma, Ogivri, Ontruzant
- Non-Preferred Part B Drug Request Form: Lemtrada
- 2023 Non-Preferred Part B Drug Request Form: Nyvepria, Udenyca, Ziextenzo
- 2023 Non-Preferred Part B Drug Request Form: Granix, Leukine, Neupogen, Nivestym
- 2023 Non-Preferred Part B Drug Request Form: Herzuma, Ogivri, Ontruzant
- 2023 Non-Preferred Part B Drug Request Form: Lemtrada
- 2023 Non-Preferred Part B Drug Request Form: Zirabev
Elderplan uses OPTUM as our Claims Editing Software.
Integration of Community Oriented Recovery and Empowerment (CORE) Services
The New York State Department of Health (DOH), Office of Mental Health (OMH) and Office of Addiction Services and Supports (OASAS) finalized the integration of behavioral health (BH) services into the Medicaid Advantage Plus (MAP) product line benefit package, effective January 1, 2023. As a result, Elderplan Plus Long-Term Care (HMO D-SNP) now covers behavioral health (mental health and addiction) services/benefits for eligible members.
In order to coordinate care for your patient and our Member, please submit all requests to our partner, Carelon Behavioral Health, at the following address: [email protected]