Claims and claim status

Find claim-status contacts and document destinations. A billing address, appeal address and original-claim address are not interchangeable.

claims

BIN 800004 — member reimbursement claims form

Official page read

Phone800-771-4648Fax

866-552-8939

Published email

clinical@medimpact.com

Completed BIN 800004 member reimbursement claim form and required receipt documentation as printed on page 2; not PA intake or generic benefit inquiries.

Published hours

Claims-form questions: 8 a.m.-9 p.m. Central; days not stated

Product, plan and location

Confirm the exact product or service
National contact — confirm product and location

Mailing address

MedImpact 10181 Scripps Gateway Ct. San Diego, CA 92131

BIN 800004 member reimbursement claim forms and paid-pharmacy receipt documentation only; the general reimbursement form has a different North Canton address.

The current member page explicitly links this as the Member Reimbursement Form for BIN 800004. Its page 2 confirms the inherited phone/fax pair for reimbursement, not prior authorization. Visual review confirms clinical@medimpact.com despite overlapping extracted text. Use the BIN shown on the member card. Current linked PDF metadata was modified April 16, 2026; its copyright is 2024 and legacy form text also remains. Older keyedclaims@elixirsolutions.com / P.O. Box 3047 leads are not used.

View source ↗ · Source checked 2026-10-22 · elixir members ↗ · elixir contact ↗ · elixir home ↗

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

claims

General member reimbursement — current DMR form

Official page read

Phone

No phone listed for this route

Fax

866-646-1403

Published hours

Not published in this record

Product, plan and location

Confirm the exact product or service
National contact — confirm product and location

Mailing address

MedImpact 7835 Freedom Avenue NW North Canton, OH 44720

Completed general member-reimbursement form and requested receipts under that form; not the separate BIN 800004 reimbursement form.

The current member page lists this general reimbursement form separately from the BIN 800004 form. The provider-page copy has identical bytes. Current footer is copyright 2024 / E12024. No phone or submission email is added where the form does not publish one.

View source ↗ · Source checked 2026-10-22 · elixir members ↗ · elixir providers ↗ · elixir general dmr ↗

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Call preparation · editorial guide

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Find claim-status contacts and document destinations. A billing address, appeal address and original-claim address are not interchangeable.

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Claim number, service dates and billed amount
Submission acknowledgement and remittance
Provider billing identifiers

Questions to resolve

Was the claim received and accepted for processing?
What specifically prevents payment or final processing?
Is a corrected claim, reconsideration or appeal the right route?

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