If you would like to view claim status and EOB in EZ-NET portal, please send an email to billing@elementcare.org with the below information. 

Subject Line: EZ-NET Access
 
 
CONTACT US


 






WEBSITE

http://www.elementcare.org/


EDI Insurance Division

Phone: (781) 715-6672
   

IMPORTANT NOTICES

90-Day Billing Deadline and Other Denials

The Executive Office of Health and Human Services regulations mandate that all claims must be received within ninety (90) days of the date of service or within ninety (90) days of the date of an Explanation of Benefits (EOB) from another insurer. If a claim is submitted for payment within ninety (90) days of the date of receipt of an EOB from another insurer; a copy of that other insurer's EOB must be included with the resubmitted claim.

A claim submitted beyond the appropriate time period will be denied with an appropriate denial letter from Element Care. Element Care may also deny a claim, withhold payment for a claim, or recoup payment for a claim that is not authorized or where the Provider or the employee of the Provider has been excluded, suspended, or debarred from participation in Federal & State health care programs or Federal & State procurement and non-procurement programs.

Appeals

You have ninety (90) days from the date of the original denial or ninety (90) days from claim adjudication (EOB) to submit an appeal. An appeal will only be accepted in writing and must include the following:

  • The claim
  • Any remittance advise on which the claim has appeared (if applicable)
  • Proof of receipt (i.e. fax transmittal report, certified mail receipt)
  • A cover letter stating the reason for the request
  • The name and address of the person or provider appealing
  • A statement of any additional evidence to support the appeal


All inquiries and correspondence should be mailed to:


Element Care

                                  235 Woodland North

                       Lynn, MA 01904

Attn: Appeals Committee
AUTHORIZATIONS


Authorizations cannot be updated via EZ-NET. Please contact Element Care for all authorizations inquires.


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