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Medica Mailing Addresses for Claims

Medica 

Medical & dental claims for Medica members should be sent to the appropriate address below depending on the Medica product. Minnesota providers are required to submit claims electronically.

The Claim Adjustment or Appeal Request Form is used:

  • When a provider has additional data that should have been submitted on the original claim or has a need to correct data that was sent incorrectly on the original claim
  • When a provider is requesting the reconsideration of a previously adjudicated claim, including late claims, but there is no additional or corrected data to be submitted. The appeal must be submitted within 12 months of the original disallow date.

Claim Adjustment or Appeal Request Form (DOC)

NOTE: Minnesota providers must follow the MN AUC guide for electronic submission of void/replacement claims.

For Medica members with group/policy #IFB, send to:
Medica
PO Box 981647
El Paso, TX 79998-1647
Medica payer ID: 12422

For all other Medica members, send to:
Medica
PO Box 30990
Salt Lake City, UT 84130
Medica payer ID: 94265


Medica Behavioral Health 

Medica Behavioral Health℠ handles mental health/substance abuse (MH/SA) services for Medica members. Related claims should be sent to:

For Medica members with group/policy #IFB, send to:
Medica
PO Box 981647
El Paso, TX 79998-1647
Medica payer ID: 12422

For all other Medica members, send to:
Medica Behavioral Health
PO Box 30757
Salt Lake City, UT 84130-0757
Medica payer ID: 94265


Delta Dental

Delta Dental® claims should be submitted to:

Delta Dental of Minnesota
PO Box 1519
Minneapolis, MN 55440-1519 

Medica payer ID: 94265


OptumHealth Care Solutions, Physical Health

OptumHealth℠ Care Solutions, Physical Health handles chiropractic care for Medica fully insured and self-insured members other than Medica SelectCare℠ enrollees. Chiropractic claims for Medica members who access this network should be submitted to:

For Medica members with group/policy #IFB, send to:
Medica
PO Box 981647
El Paso, TX 79998-1647
Medica payer ID: 12422

For all other Medica members, send to:
Medica
PO Box 30990
Salt Lake City, UT 84130
Medica payer ID: 94265


Magellan Healthcare

Magellan Healthcare managed chiropractic care for SelectCare enrollees. Chriopractic claims should be submitted to:

Magellan Healthcare
7805 Hudson Road, Suite 190
Woodbury, MN 55125

Date: 6/4/2020 4:02:22 PM Version: 4.0.30319.42000 Machine Name: PWIM4-CDWEB01