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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 Individual and Family 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 Individual and Family.

Supported

Eligibility

EDI 270/271

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

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 Individual and Family.

Supported

Other aliases

Also known as

  • 11171
  • 12422
  • 6694
  • 6799
  • MEDIFB
  • Z95382
  • Medica2
  • Medica2 IFB
  • MEDICAIFB

Payer policies

Medica Individual and Family policies

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

Search all 283 Medica Individual and Family policies by CPT code, keyword or policy number →

Routing reference

Medica Individual and Family 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 Individual and Family payer name, operating states, and transaction-specific payer IDs
Payer nameMedica Individual and FamilySource: Substrate payer directory · data last changed
Operating statesIA, KS, MN, MO, ND, NE, OK, WISource: Substrate payer directory · data last changed
837P professional claims payer IDStedi12422Source: Stedi payer catalog · catalog dated · matched by payer ID
837I institutional claims payer IDStedi12422Source: Stedi payer catalog · catalog dated · matched by payer ID
835 ERA payer IDStedi12422Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDStedi12422Source: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDAvaility12422Source: Availity payer catalog · catalog dated · matched by payer ID
276 claim status payer IDStedi12422Source: Stedi payer catalog · catalog dated · matched by payer ID
276 claim status payer IDAvaility12422Source: 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 Individual and Family. 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 records: MEDICA INDIVIDUAL AND FAMILY, MEDICA2. 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 Individual and Family. 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 Individual and Family phone numbers
Channel and numberPayer NotesDepartmentSpecialties
phone(800) 848-8327Behavioral healthBenefit context: Non-Covered
  • Medica Behavioral Health
Mental Health
phone(800) 458-5512
  • MEDICA IFB

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

Not affiliated with Medica Individual and Family 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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