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Bundled codes for maternity are deleted January 1, 2027Get ready for the change >>
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Coverage profile

Work Medica Government Programs across every published route

Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.

Claim status

EDI 276/277

The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Medica Government Programs.

Supported

Eligibility

EDI 270/271

The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Medica Government Programs.

Available

Enhanced claim status

Availity ECS
Supported

Portal claim status

Browser automation

The Substrate Claim Status Agent can check claim status via the payer portal for Medica Government Programs.

Supported

Other aliases

Also known as

  • 14514
  • 5012
  • 8860
  • MEDGP
  • MEDM1
  • Dean Health Plan BadgerCare Plus

Payer policies

Medica Government Programs policies

The first 25 of 283 public policies Substrate tracks for Medica Government Programs, by title. Links open the payer's own document; check its current version before relying on it.

Search all 283 Medica Government Programs policies by CPT code, keyword or policy number →

Routing reference

Medica Government Programs payer IDs and operating states

Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.

Medica Government Programs payer name, operating states, and transaction-specific payer IDs
Payer nameMedica Government ProgramsSource: Substrate payer directory · data last changed
Operating statesAZ, MN, NE, OK, SD, WISource: United Clearinghouse payer catalog · matched by payer name
837P professional claims payer IDStediMEDM1Source: Stedi payer catalog · catalog dated · matched by payer ID
837I institutional claims payer IDStediMEDM1Source: Stedi payer catalog · catalog dated · matched by payer ID
835 ERA payer IDStediMEDM1Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDStediMEDM1Source: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDAvailityMEDM1Source: Availity payer catalog · catalog dated · matched by payer ID
276 claim status payer IDStediMEDM1Source: Stedi payer catalog · catalog dated · matched by payer ID
276 claim status payer IDAvailityMEDM1Source: Availity payer catalog · catalog dated · matched by payer ID

Routing sources and verification

  • Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
  • Stedi payer catalogMatched by payer ID; matched record: Medica Government Programs. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
  • Availity payer catalogMatched by payer ID; matched record: MEDICA GOVERNMENT PROGRAMS. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
  • United Clearinghouse payer catalogMatched by payer name; matched record: Medica Government Programs. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗

Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.

Phone and fax contacts

Numbers vary by plan, service, and department. Check the member’s ID card before calling or sending a fax.

Phone numbers2
Medica Government Programs phone numbers
Channel and numberPayer NotesDepartmentSpecialties
phone(800) 848-8327Behavioral healthBenefit context: Non-Covered
  • Medica Behavioral Health
Mental Health
phone(800) 458-5512
  • MEDICA GOVERNMENT PROGRAMS

Numbers stated in payer eligibility responses; scope may depend on benefits, products, or departments.

Not affiliated with Medica Government Programs or BCBSA.

Confirm routing with your clearinghouse. Report an error

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

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