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Provider Training

The Medica Provider College offers online training monthly for our providers on various administrative topics. Our classes are delivered via webinar and include time for you to ask questions. We invite all business office personnel throughout the Medica service area to participate. Class topics and dates are listed below.

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Classes

Having resources at your fingertips is a great way to save you time! We routinely update our provider resources. This webinar will walk you through our self-service options, including resources on medica.com.

We'll focus on:

  • Determining member eligibility
  • Verifying if utilization management and reimbursement policies apply to services being billed
  • Verifying how a claim processed
  • Next steps for claims (e.g. appeals or adjustments)

Class Dates and Times

  • Oct. 30, 10 – 11:30 a.m.
  • Nov. 27, 10 – 11:30 a.m.
  • Dec. 18, 10 – 11:30 a.m.
  • Jan. 22, 10 – 11:30 a.m.

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Understanding all three components of a clean claim — submission, process and output — is important to ensure proper payment! This webinar will review all three in order to help you understand how they work together to facilitate the proper processing of claims.

We'll focus on:

  • Submission policies and requirements
  • 837P and 837I electronic transactions
  • Provider remittance advices (PRAs)
  • Common denial reasons
  • How to request claim adjustments and appeals

Class Dates and Times

  • Oct. 23, 10 – 11:30 a.m.
  • Nov. 13. 10 – 11:30 a.m.
  • Dec. 04, 10 – 11:30 a.m..
  • Jan. 15, 10 – 11:30 a.m.

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Claim appeals and adjustments are an important tool to ensure proper claims payment! This webinar will review the process for submitting appeals, adjustments and supporting documentation to Medica.

We'll focus on:

  • The different avenues for submission, and when each is appropriate
  • When appeals and adjustment requests are appropriate
  • Where to find the necessary forms on Medica.com
  • Tips for making sure that your appeal or adjustment request contains the information that supports the desired outcome in an accessible format
  • The options available if you disagree with a decision on an appeal or adjustment request

Class Dates and Times

  • Nov. 06, 10 – 11:30 a.m.
  • Dec. 11, 10 – 11:30 a.m.
  • Jan. 08, 10 – 11:30 a.m.

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Medica offers different Medicare plans to fit our members’ needs. This course will review information to assist providers in better understanding the different Medicare plans Medica has available.

We'll focus on:

  • The differences between Medicare Advantage and Cost plans
  • Changes for 2019
  • When Medica follows Centers for Medicare and Medicaid Services (CMS) guidelines
  • When to bill Medica vs. Medicare as primary payer
  • Upgraded services offered by plans
  • Billing requirements and reimbursement

Class Dates and Times

Time will also be provided for questions and answers as part of this discussion.

  • Nov. 07, 10 – 11:30 a.m.

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Send Us Your Feedback

Is there something you would like to learn more about? We're always working to expand our educational offerings. Send an email to let us know what you'd like to learn more about.

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Past Course Materials

Missed a training or want to review the participant guide? No problem. You can access the participant guide from previous webinars for your reference.

Participant Guides

Date: 10/23/2018 2:39:24 AM Version: 4.0.30319.42000 Machine Name: PWIM4-CMSWEB01