Claims Submission
Element Care is the payer for services provided to our participants. Providers are required to submit all claims directly to Element Care for processing.
Claims must be submitted within 90 days from the date of service. Claims submitted after this timeframe may be denied in accordance with our timely filing requirements.
Element Care accepts electronic claims submission only. Providers should submit claims through the Optum clearing house using the following information:
- Payer Name: Element Care
- Payer ID: 04326
Electronic submission is the preferred and required method to ensure timely and accurate processing. You may also opt in to receiving your 835 remittance advice is through Optum.
EZ Net Portal Access
For your convenience, Ez Net allows providers to:
- Verify participant eligibility
- Check claim status
- Review payment information
We strongly encourage providers to utilize the portal for real-time access to claim and eligibility information.
Pharmacy Benefits
Pharmacy benefits for Element Care participants are processed through Element Care’s PBM. Participants receive all medications from any of their providers through our community health center pharmacy partners, delivered to their homes, often in adherence packaging to make it easier to manage.
Pharmacies can bill for prescriptions written by Element Care providers using the following information:
- BIN 022188
- PCN PSTMEDD
- GRP ECPH2222
Pharmacy-related inquiries, including coverage, should be directed to the participant’s care team or to Element Care Provider Services.
Contact Us
If you need assistance with claims submission or would like to learn more about available submission options, please contact Element Care at:
- Phone: 781-715-6616
- Email : billing@elementcare.org
Our team is available to support you and ensure a smooth claims submission process.