Use the Medica address below for new claims, resubmissions, claim adjustments and late claims:
Medica
PO Box 30990
Salt Lake City, UT 84130
For claim adjustments, mail a Medica Adjustment Request Form to the address above. This would occur when a payment has already been made by Medica but a change is necessary and is within 180 days of the original provider remittance advice (PRA) check date, unless a provider contract indicates otherwise.
For late claims, mail a Medica Late Claim Appeals Form and relevant documentation to the address above.
Download Adjustment Request Form.
Download Late Claim Appeals Form.
Providers may call Medica’s Provider Service Center at 1-800-458-5512 to check on a claim if it isn’t processed within two weeks.
Note: Medical claims and medical/dental claims for Medica members should be sent to the appropriate address below depending on the Medica product.
Medica Behavioral Health handles mental health/substance abuse (MH/SA) services for Medica members. Related claims should be sent to:
Medica Behavioral Health
PO Box 30757
Salt Lake City, UT 84130-0757
Dental claims should be submitted to:
Delta Dental of Minnesota
PO Box 1519
Minneapolis, MN 55440-1519
ACN handles chiropractic care for Medica fully insured and self-insured members other than SelectCare enrollees. Chiropractic claims for Medica members who access this network should be submitted to:
Medica
PO Box 30990
Salt Lake City, UT 84130
HSM manages chiropractic care for SelectCare enrollees. Chiropractic claims should be submitted to:
Health Services Management, Inc.
7805 Hudson Road, Suite 190
Woodbury, MN 55125
Return to Billing and Reimbursement.