Member Care
Medica has several resources that participating providers can direct members to for answers and services. Medica recognizes that members often look to their health care providers for answers regarding their medical coverage. In most instances, the provider will not be able to (and is not expected to) answer all the specifics related to a particular member’s benefit document. Please encourage members to review their benefit document, by calling the Customer Service number on the back of their ID cards or checking myMedica.com.
The following are Medica's member care resources:
Members should call Customer Service for the following: - Member enrollment information
- Benefit document explanation
- Clerical errors, including misspelled names, a wrong address or a wrong gender listed
- Clarification of copayments, coinsurance and deductibles
- Clarification of, or requests for, member packet information, e.g., a Provider Directory, replacement Medica identification cards, etc.
- Information about, or application for, conversion to an individual policy when terminating coverage from a group policy
- Status change forms to add/delete a dependent or to change address
- Other information that affects the member’s coverage or benefit determinations
- Requests for interpreter services (hearing impaired and foreign language)
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Interpreter services are available to members only during office visits with participating providers.
Requests for interpreter services may be submitted by the hearing-impaired member (for all groups), a family member, a friend of the member, or a participating provider by calling the appropriate Customer Service number listed on the back of the member's identification card.
Members enrolled in Medica's commercial and most Medicare products do not have a foreign language interpreter benefit, Commercial Customer Service representatives are able to assist non-English speaking members. Representatives can use the Language Line to conference call with interpreters and members. The service has interpreters trained in 140 languages and, in most cases, will connect to an interpreter within 60 seconds.
Requests for foreign language interpreter services may be submitted by the member (Medica Choice Care, Medica DUAL Solution and Medica MinnesotaCare members only), a family member, a friend of the member, or a provider by calling Medica Interpreter Service.
For Minneapolis/St. Paul Metropolitan Area, call (952) 992-2292. Separate Lines have been established for specific languages: - Russian (952) 992-2294
- Vietnamese (952) 992-2295
- Hmong (952) 992-2296
- Spanish (952) 992-2297
- Somali (952) 992-2260
For Greater Minnesota, call (800) 601-1805. When a locally contracted agency cannot be used, arrangements can be made to use the Language Line.
Providers may call Medica’s interpreter services coordinators directly at (952) 992-2293 to: - Ask questions about Medica’s interpreter services.
- Request names of Medica’s contracted vendors.
- Provide feedback about an interpreter.
Most languages are covered by the interpreter service ( Medica Choice Care, Medica DUAL Solution and Medica MinnesotaCare members only), including: - Arabic Greek Norwegian
- Cambodian Hebrew Polish
- Cantonese Chinese Hindi Portuguese
- Czech Hmong Romanian
- Danish Hungarian Russian
- Dutch Italian Somali
- English Japanese Spanish
- Finnish Korean Swedish
- Flemish Laotian Thai
- French Mandarin Chinese Vietnamese
- German
Generally, Customer Service needs two days to arrange interpreter services. Customer Service should be notified as soon as the appointment with the participating provider is scheduled. Customer Service is required to supply the following information to the interpreter service: - Date and time of appointment.
- Approximate length of appointment.
- Provider’s name and address.
- Brief explanation of medical services (e.g., routine, OB/GYN).
- Name of member.
- Member identification number.
- Phone number where member can be reached to confirm interpreter services.
If the member is eligible for interpreter services (as defined in the member’s benefit document), Medica will call to request an interpreter.
If an interpreter is available, the Medica service representative will confirm this with the participating provider and member by telephone.
If an interpreter is not available, or the associated medical services are determined not to be eligible, the Medica service representative will notify the member by phone (TTY if necessary). If the request was from an individual other than the member, notification will be made by phone to the requester.
Advance notification of 24 hours is necessary to cancel interpreter services. The participating provider’s office should notify Medica if an appointment is cancelled for which an interpreter has been scheduled.
The contracting vendor provides the interpreter with an interpreter work order form, which lists the time, date, name and location of the appointment. It is very important that a clinic staff member sign this form when the interpreter arrives for the appointment and again when the appointment is completed. This way, Medica can track how long the interpreter is at an appointment and verify claim accuracy.
Providers should not sign the work form if services are not completed.
All hospitals are required to provide interpreters as needed for all inpatient and outpatient services. This includes emergency situations. Parrticipating providers who schedule inpatient or outpatient services at hospitals should alert the hospital that the patient needs an interpreter.
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Medica CallLink is a 24-hour-a-day, 365 day-a-year health information and referral service, staffed by registered nurses and referral specialists.
Medica CallLink provides:
- Registered nurses to offer appropriate care options.
- Audio tapes on a variety of health care subjects.
- Referrals for physician selection and service.
To reach Medica CallLink, call: (800) 962-9497. Hearing impaired with TTY Machine should call the National Relay Center at (800) 855-2880 and request (800) 962-9497.
Medica CallLink staff can provide:
- General health information.
- Specific medical information such as:
- What a disease is
- What can be expected in the treatment of a disease
- What kinds of providers may be involved in the treatment
- Which support groups in the area may provide more information
- Where to find written materials about specific topics.
- Sources of first aid/home care for minor injuries.
- Locations of Medica participating providers.
- Locations of Medica-sponsored health-related classes and services within the community.
- Locations of urgent care centers or providers with evening and weekend hours.
- Recommendations on whether the member should set up a regular appointment with a participating provider or go to a participating urgent care center or to an emergency room for treatment of a medical condition.
Medica CallLink helps control health care costs by:
- Directing members to appropriate, alternative places of care such as urgent care centers.
- Resolving minor medical treatment issues with the member by phone rather than referring cases to a health care provider.
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Medica Optum Employee Assistance Program is a program designed to help members manage personal problems. This program works in coordination with Medica when a member needs assistance with mental health/substance abuse issues, legal issues, financial concerns, family problems or workplace stress. Optum Employee Assistance Program can help by identifying the problem when it first surfaces and developing the right resources.
Medica Optum Employee Assistance Program provides:
- Immediate assistance 24 hours every day at (800) 626-7944. TTY users can call the National Relay Center at (800) 855-2880 and request (800) 626-7944.
- An experienced, professional staff. All Medica Optum Employee Assistance Program's counselors have advanced degrees and experience helping people deal with a wide range of problems.
- Problem assessment.
- Appropriate, effective, quality assistance and/or referral for a broad range of problems.
The benefits to the member of Medica Optum Employee Assistance Program's assessment and assistance include:
- Immediate assistance by phone, especially for crises.
- Better understanding of the problem at hand.
- Better understanding of the mental health/substance abuse service system.
- More effective communication with a mental health/substance abuse intake counselor, thus providing more efficient assistance.
- Assistance for non-mental health/substance abuse problems, specifically for daily living, work, legal or financial concerns.
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Provide-A-Ride is a transportation program at Medica designed to provide non-emergency transportation for ambulatory Medica Choice Care and Medica DUAL Solution members who otherwise could not get to their appointments.
Through agreements with many vendors-including areas outside the Twin Cities metropolitan area-buses, cabs and volunteer drivers are available.
To Request Transportation
Members who are ambulatory may request transportation by calling Provide-A-Ride at the numbers listed below. Transportation coordinators are available Monday through Thursday from 7:30 a.m. to 4 p.m., and Friday from 9 a.m. to 4 p.m.
Minneapolis/St. Paul metropolitan area: (952) 992-2292
Outside metropolitan area: (800) 601-1805
After hours and on weekends and holidays, members may call Medica CallLink at (800) 962-9497. TTY users can call the National Relay Center at (800) 855-2880 and request CallLink at (800) 962-9497.
Members should call Provide-A-Ride as soon as an appointment is scheduled with a participating provider in order to allow time for appropriate arrangements to be made and for any transportation passes or tokens to be received.
To arrange transportation Provide-A-Ride needs this information:
- Date and time of appointment.
- Approximate length of appointment.
- Provider’s name and address.
- Name of member.
- Member identification number.
- Phone number and address where member can be reached.
Provider office staffs are requested to place a Medica sticker on members’ transportation passes after they have completed their appointments. This allows them to receive transportation back to their homes. These stickers can be obtained by calling (952) 992-2292 or (800) 601-1805. If stickers are not available, office staff members may initial and date the transportation passes.
Transportation services may be available for Medica MinnesotaCare members who are pregnant or children under age 21. For more information, call MinnesotaCare at (651) 297-3862 or 1-800-657-3672, or TTY: (800) 627-3529.
Brochures describing the Provide-A-Ride program are available in English, Hmong, Vietnamese, Russian and Spanish. Call Provide-A-Ride at (952) 992-2292 or (800) 601-1805.
Address correspondence to: Medica State Public Programs
Provide-A-Ride
Route CP 335
PO Box 9310
Minneapolis, MN 55440-9310
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