We are pleased to announce that, effective April 1, 2025, HCP will partner with Elderplan, a not-for-profit Medicare Advantage plan with a 40-year history of serving Medicare and dual-eligible (Medicare & Medicaid) patients at all levels of health. Elderplan’s commitment to quality is reflected in its 5-star ratings for Health Care Quality and Rating of Health Plan in the 2024 CMS CAHPS Survey.
Through this partnership, your practice will receive a per-member-per-month (PMPM) payment from HCP for each Elderplan patient attributed to your panel. This payment is designed to support your practice in proactive patient care, including Annual Wellness Visits (AWVs), quality gap closures, and other population health initiatives.
Important Information to Know
Payment Details
Your practice will receive a PMPM payment from HCP for attributed Elderplan patients. However, it is critical that your practice continues to submit claims directly to HCP for services rendered. These claims are necessary for risk adjustment and HEDIS data capture. Claims will not be reimbursed separately; the PMPM payment from HCP serves as your compensation under this arrangement.
Claim Submissions
HCP-Contracted PCPs should submit claims and encounters directly to HCP. HCP will compensate PCPs for services provided to Elderplan Members through the PMPM reimbursement cap. Submit claims/encounters to HCP.
HCP-Contracted Specialists should submit claims and encounters directly to Elderplan, either electronically or by paper submission. Please refer to Elderplan’s Provider Manual available for detailed claims and encounter submission instructions.
Additional Resources
Your dedicated HCP Representative
Contact your HCP Provider Relations Specialist or HCP’s Customer Engagement Center at (800) 877-7587, available 24/7.
Elderplan Provider Portal
Visit Elderplan’s Provider Portal to access key information, including claims status, authorizations, member eligibility, and more, saving your office valuable time.
Elderplan Provider Customer Service: (800) 353-3765, Option 2; Monday-Friday, 9:00 am-5:00 pm
Your dedicated Elderplan Representative
- Fatima Fernandez
Email: ffernand@mjhs.org
What to Expect Next
- If you currently have Elderplan patients, HCP will provide your patient roster
soon. - Your first PMPM payment will be issued in May, with payments continuing on a monthly basis thereafter.
- Your HCP Provider Relations Representative will work closely with your practice to support Annual Wellness Visits (AWVs) and quality cap closures, enhancing preventive patient care.
We believe this partnership will strengthen our ability to deliver high-quality care, ensuring that patients have access to Elderplan’s comprehensive benefits and dedicated support. For additional details, please view Elderplan’s Frequently Asked Questions.
Thank you for your continued partnership and commitment to high-quality care.