Payer ID
94265
94265 routes to Optum; Medica uses multiple payer IDs by product (e.g. 71890, 12422, MEDM1) via Availity. Confirm per member/product.
Timely Filing Limit (TFL)
180 days from DOS (date of discharge for inpatient); some products up to 18 months
Appeal Window
Generally 12 months from the claim processed date to submit an initial adjustment/appeal
Clearinghouse
Availity (most payer IDs); Optum for payer ID 94265
Provider Services
800-458-5512
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Varies — confirm via portal / clearinghouse
Provider Portal
https://partner.medica.com/providers
Minnesota-based, multi-state (MN/WI/IA/ND/SD/NE/KS/MO and others); also Medicare/Medicaid; now administers Dean Health Plan claims.
Values vary by plan, region, and contract and can change. Confirm in the payer portal or with your clearinghouse before filing.
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