Categorized below are various tools and forms Medica has developed to assist its provider network with understanding Medica’s billing and reimbursement processes.
Claim Submission Requirements for Facilities: How to submit claims, interpret Medica’s response and request adjustments, including Adverse Health Events and Recalled and Replace Medical Devices Policies.
Claim Submission Requirements for Professional Services: How to submit claims, interpret Medica’s response and request adjustments.
Coding Resources: Access to code updates, guidelines and frequently asked questions.
Coordination of Benefits (COB): How to handle COB claims and calculations, including Medicare claims.
Electronic Transactions: Login to view eligibility, referrals, provider number inquiry and electronic provider remittance advice (EPRA). A variety of information and tools are available for real-time transactions, such as eligibility and claim status.
Mailing Address for Claims: Contact information for submitting claims to Medica.
Provider Remittance Advice: A
summary of reimbursements made on submitted claims.Claim Analysis and Recovery: Access to analysis processes and recovery tools and forms.
Reimbursement/Claims Policies: Guidance on how to code and submit claims to Medica for covered health care services.
Return to Provider Administrative Manual.