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Medica Administrative Manual Home > Medica Points of Contact > Contact Medica
Provider Service Center 1-800-458-5512
Hours of Service
Monday - Thursday from 8:30 a.m. - 5 p.m.
Friday from 9 a.m. - 5 p.m.
Provider appeals on behalf of members for claims issues when denied as member liability.
Medica handles chiropractic care for members with group/policy number "IFB".
OptumHealthSM Care Solutions manages chiropractic care for Medica members (other than SelectCareSM and LaborCare® enrollees).
Health Services Management (HSM) manages chiropractic care for SelectCare and LaborCare enrollees.
651-501-9635 or 1-800-432-3640
For high risk pregnancy, chronically or catastrophically ill members.
Handles provider appeals on behalf of members and providers for reconsideration of a non-coverage determination that requires clinical review against medical policy guidelines.
Handles inquiries from those interested in joining the Medica provider network, as well as contracting questions and implementation issues.
Learn more about participating in Medica's provider network or call the Medica Provider Service Center toll free at 1-800-458-5512.
Credentialing & Recredentialing
Handles questions related to the credentialing and re-credentialing process as well as status of applications.
Providers need to be contracted with Medica (new providers should see "Contracting" above).
Learn more about the credentialing process »
Demographic Changes: Participating Practitioners/Sites
Use the secure provider demographic-update online tool (PDOT) to make site-level and individual practitioner adds, terms or changes for Medica and Patient Choice products. Make demographic changes such as:
Additional practitioner change options are available by submitting the Minnesota Uniform Practitioner Change form. For additional contract-related requests, contact your contract manager.
To learn more or make a change request, see Demographic Change Requests.
Delta Dental of Minnesota answers dental claims questions.
Electronic data interchange (EDI) information, products and support.
Responsible for automation of provider-to-health plan transactions, including implementation and support of HIPAA-mandated transactions.
or call the Provider Service Center toll-free at 1-800-458-5512
Fraud, Waste and Abuse Training and Reporting
Confidential phone line to report suspected fraud.
952-992-2237 or 1-866-821-1331
Learn more about Fraud, Waste and Abuse »
Inpatient Admission Notifications
Handles notifications for current hospital inpatient admissions related to Medica members.
Medical claims inquiries, medical-related dental issues and general coding questions..
1-800-458-5512, option 1, then option 1 for the automated system, or option 2 to speak with a representative.
Mental Health & Substance Abuse Services
For group/policy number "IFB", Medica handles benefits, claim issues and service access questions using the Optum SelectCare network. Optum SelectCare handles authorizations for most inpatient services.
Medica Behavioral Health provides and manages mental health and substance abuse (MH/SA) services for most Medica members; handles benefits, prior authorization, claims issues, and service access questions.
SelectCare MH/SA network provides and manages services for some SelectCare enrollees.
Benefits, Claims, Service Access:
Rx claims processing via electronic submission and general information via telephone.
Responds to drug formulary exceptions and drug prior authorization requests (accepted by fax or phone only).
CVS Caremark inquiries »
MedImpact inquiries »
Population Health Management and Health Coaching
Development and implementation of programs, such as health management and preventive health programs, which are designed to support the health needs of members within specific populations, including whole-patient coaching for those with multiple health conditions.
Provider Literature Request Line
Order provider directories, provider communications, referral forms, formularies, administrative manuals, adjustment request forms, late claim appeal forms, practitioner change forms and other materials printed on paper.
1-800-458-5512, option 1, option 5,
Provider Service Center
This call center responds to provider questions on claims issues, benefits, eligibility, provider numbers, and other topics.
There is a self-help feature for automated information as well as the option to talk to a representative. Several options are also available as electronic transactions online.
Handles member complaints regarding quality of care and/or service for care received, as well as required quarterly quality-of-care complaint reports from Minnesota clinics. Also conducts medical record reviews and site visits for quality improvement.
1-800-625-7824 or 952-992-3208
Handles Medica EssentialSM, Medica Elect®, and ACO administrative referral authorizations and coordination of referral changes by member care coordinators.
SelectCare cannot verify eligibility or benefits. These questions should be directed to payer listed on enrollee’s ID card.
SelectCare cannot mail out Provider Directories.
952-992-2500 or 1-800-858-9060
Social Services (coordinates community resources)
Commercial, Medicare products
State Public Programs (SPP)
Prior authorization of procedures or coordination of services such as transplant, home health, skilled nursing facilities or durable medical equipment.
Provider Service Center
Monday – Thursday, 8:30 a.m. – 5 p.m.
Friday, 9 a.m. – 5 p.m.
View other points of contact »
Claims tools and forms
Provider administrative manuals
Fraud and Abuse