- 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.
Questions? Call Elderplan today.
1-800-353-3765
[TTY: 711]
Hours of Operation:
8 a.m. to 8 p.m., 7 days a week