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How do you play them?

You can't see the flag placement too well. you just know its either back middle or front...

well for me, i try to pick a spot in the background (Tree, House, ETC), where I estimate the flag is, i never try to fire at pins to much but be sure to take the extra club, try to land it in the middle and run it there or stop in the middle of the green

As old as I am, I seem to have a fair sense of depth and position. I play all shots from 80 ---in ---at the Pin. Been workin real well as the putter can DO!

Ol Spoon

my course has a few elevated greens and they tend to place the pin near the front or left or right,this is to coax you to go for the pin and perhaps hit the hump and roll back down or roll off the sides,i go for the middle width and depth and then try for the glory putt.

If I'm playing a new course and I'm not familiar with the layout of the green, and IF I'm riding a cart and not holding up a group behind me by doing so, I will drive up far enough to get a basic view of the green. That helps. But I won't do that if there's a group behind me waiting.

Taking those things into consideration, I factor in the difference in elevation. This is all based on feel, just like an in-between pitch shot or very long putt. It is also based on how I'm hitting the ball that day. If I'm catching everything on the screws, dead-solid perfect, I might not even take an extra club. Or, then again, I might take as much as one or even two clubs more if I don't feel comfortable with the shot.

After that, it's all about visualizing the shot. Visualizing too the manner the ball will react after hitting an elevated green, which generally means the ball will release quite a bit after it hits. But it all starts with picking the right club, making the proper swing, and hitting it to the target. In many cases, I have actually hit a better approach shot than I think when I don't see the flag. ;)

It's all about feeling the shot, and accounting for those things I mentioned. There's really no science to it, other than making a good swing.