endstream endobj startxref A^8=3;N PK ! Medica offers Medica Choice Care PMAP (Prepaid Medical Assistance Program) and Medica . 13 digits Electronic Appeal Submission : Log in to Medica Provider Portal. Medica Behavioral Health claims should be submitted to: Medica PO Box 30757 Salt Lake City, UT 84130 If you are not able to submit electronic claims, please update your records to make sure you're using the correct addresses for the type of claim you're submitting -. Claim Adjustment or Appeal Request Form (DOC) Claim Numbers . Medica Government Programs Route CW299 PO Box 9310 Minneapolis, MN 55440-9310; For Medica members with Payer ID #94265, send checks to: Medica PO Box 30990 Salt Lake City, UT 84130; Medica Field Service will process the adjustment based on receipt of the refund check. BCBS AZ providers submit to payer ID 53589 . Medica.con-NemberSite Medic. Box 6090, De Pere, WI 54115-6090. Employer-provided Discover an insurance plan that works for you and your employees Medicaid Get no-cost coverage and support for your well-being. PO Box 982805 El Paso, TX 79998-2805 651-662-2745 : Blue Cross PO Box 982800 El Paso, TX 79998-2800 . Payer ID: 71890 ID: 1234567891 Group A0042 Name: JOHN Q ACOMWlSE01/STD/A0042 JANE Q Samplemember JOE Q Samplemember Direct those calls to 800-822-9993. ABOUT US. 1435. hbbd```b``"gI=2, ,D2'H`&Yddf1 :dgHS 1Q$(?cO DA PPO - HealthEOS by MultiPlan, P.O. PK ! For those members who are dual-eligible, Medica will coordinate benefits with their primary . Availity Client Services: 1-800-282-4548 Delta Dental of Minnesota . Provider returns a Medica check. Call us toll-free at 800-228-6080 for all policies except those written under Medico Corp Life Insurance Company. Transplant: Call Medica's Provider Service Center toll-free at 1-800-458-5512 for details Claim Submission Claims should be submitted as indicated on the back of the member ID cards, since it depends on MN 55121 Magellan 7805 Rd, Ste Woodbury, MN 55125, 41150 I Magellan Utilization Prior Medicacom or cal Customer Serwce cr Provider Service Medica includes Medita Health Plan Sdutons Medica. Our Plans Coverage you can count on Individual and family Protect you and your family with a personalized health plan Medicare Find quality care that meets your needsand your budget. Minneapolis, MN 55440-9458 . 0 All other claims (Badger Care Plus and non-PPO) - Quartz, P.O. Eagan, MN 55121- 0342 . 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Medica PO Box 21051 Eagan, MN 55121-0051 Or fax this form to: 952-992-1427 Or submit this form electronically 71890, 53589, or 88090 send to: Medica PO Box 211435 Eagan, MN 55121-0051 Or fax this form to: 952-992-3024 Or submit this form electronically MEDM1 send to: Medica PO Box 21342 Eagan, MN 55121-0342 Or fax this form to: 952-992-3899 HealthPartners - Health Plan - Dental . ^7 _ [Content_Types].xml ( KO0#5n@5ec H[c~:i PO Box 21342 . 400 0 obj <> endobj Ag>NO[.. $Xqiy*"N"B0Z Ll"5JU'H(;;_H]1qHh HealthPartners Dental Claims PO Box 1172 : Minneapolis, MN 55440-1172 952-853-8861 . .X,2FsK0s#"-C7>Oys=EUpQQpV>9\M"4KfRb k(NR*"'$qP),pOPLRjXSDtH*r!E.>[U|p cpVE!7|+mAq4.D{\nt+a/rS0k3 4Ld w,A dSKWaw/+6wj\E0F?;M=E Z},AT:{TIo{f^:GvPw?QsqmVH:;Z Medica PO Box 211435 Eagan, MN 55121. Medica Health Plans Supplement Inc. Florida: For Claims: PO BOX 141368 CORAL GABLES, FLORIDA 33114-1368 For Appeals: PO Box 211435 Eagan, MN 55121: 78857: 952-992-3024: Well Med Health Insurance: PO Box 400066 San Antonio, TX 78229: WELM2: 1-888-781-9355: Preferred Care Partners Supplement: }TlVJdBl6} Electronic payer ID: MEDM1. 866-516-5616 : PO Box 1328 . YOUR MEMBER ACCOUNT gE~wYo=6]d1tQ8. Fax 402-496-8199 Mail Medico Insurance Company or Medico Life and Health Insurance Company TeL : +974 44 91 39 44 | Fax : +974 44 18 15 49. To return a check to Medica use the following process: %%EOF ) ? Electronic Data Interchange (EDI) Medica.com Provider Portal. 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