Skip to Main Content
Administrative Resources

Medica Administrative Manual Home > Billing and Reimbursement  

Billing and Reimbursement

Claim Analysis and Recovery: Access to analysis processes and recovery tools and forms.

Claim Submission Requirements for Facilities: How to submit claims, interpret Medica's response and request adjustments.

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.

Commercial Fee Schedule Update Policy and Commercial Fee Schedule Release Policy: Guidelines for commercial fee schedule implementation at Medica.

Coordination of Benefits (COB): How to handle COB claims and calculations, including Medicare claims.

Electronic Transactions: Log in 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.

Interim Rate Changes from CMS: How to notify Medica of a CMS interim rate change.

Mailing Addresses for Claims: Contact information for submitting claims to Medica.

Provider Remittance Advice: A summary of reimbursements made on submitted claims.

Reimbursement Policies: Provides payment methodology for medical and surgical services and supplies.

Date: 6/4/2020 4:59:17 PM Version: 4.0.30319.42000 Machine Name: PWIVE-CDWEB01