Coverage profile
Work Medical Mutual 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 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Medical Mutual.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Medical Mutual.
Enhanced claim status
Availity ECSPortal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Medical Mutual.
Appeals agent
AI appeals workflowThe Substrate Appeals Agent can submit appeals for RFIs, medical record requests, downcoding reconsiderations, and more via the payer portal for Medical Mutual.
Other aliases
Also known as
- 10126
- 10911
- 14458
- 29076
- 31117
- 4423
- 9753
- CB833
- MMPHX
- MMUTOH
- SX057
- SX057MA
- TLU03
- TNXLZ
- TSTMED
- Consumer's Life
- Medical Mutual of Ohio
- MUTUAL MEDICAL
- MUTMED
2027 maternity billing research
When does Medical Mutual change OB/GYN billing?
RP-202701, created and initially effective 01/01/2027, reimburses maternity care by the separately reported component, including antepartum care, labor management, delivery, and postpartum care. Antepartum care must be reported with the appropriate E/M code and modifier TH. 0500F is billed on the initial visit with that E/M code, modifier TH, and a pregnancy-related ICD-10 diagnosis, and is not separately reimbursable. Maternity care codes are not eligible for dates of service on or after January 1, 2027. Labor management may be reported once per calendar date and is not separately reimbursable for a scheduled or planned cesarean when labor does not occur. Multiple-gestation vaginal delivery is one appropriate vaginal delivery code per fetus; only one cesarean delivery code is eligible. Immediate maternal postpartum care on the delivery date is included in delivery care. The policy names Medical Mutual of Ohio, Medical Mutual Services, LLC except Mutual Health Services, Medical Health Insuring Corporation of Ohio, and MedMutual Life Insurance Company.
- Transition start
- Services follow the date each service is rendered, not the claim billing date
- Billing start
- 2027-01-01
- Published
- 2027-01-01
- Current As Of
- October 2026
Scope: Commercial and Marketplace (Fully-Insured and Self-Funded), and Medicare Advantage. Medical Mutual of Ohio, Medical Mutual Services, LLC except Mutual Health Services, Medical Health Insuring Corporation of Ohio, and MedMutual Life Insurance Company
Maternity Care Services Reimbursement Policy RP-202701. Verify the payer source before claim submission.
Frequently asked questions
Medical Mutual payer FAQs
How do I check claim status with Medical Mutual?
Providers check Medical Mutual via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
Can I automate Medical Mutual portal follow-up?
Yes — portal retrieval is required when 276/277 is missing or stale. See payer portal automation and learn why 276/277 is not enough.
What is the payer ID for Medical Mutual?
The primary payer ID for Medical Mutual is 29076. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What is the provider portal for Medical Mutual?
The provider portal for Medical Mutual is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for Medical Mutual?
The 837P and 837I payer ID for Medical Mutual is 29076 via Stedi.
What is the 835 payer ID for Medical Mutual?
The 835 payer ID for Medical Mutual is 29076 via Stedi.
What is the 270 payer ID for Medical Mutual?
The 270 payer IDs for Medical Mutual are 29076 via Stedi and 29076 via Availity.
What is the 276 payer ID for Medical Mutual?
The 276 payer IDs for Medical Mutual are 29076 via Stedi and 29076 via Availity.
What states does Medical Mutual operate in?
Medical Mutual operates in OH and WI.
Routing reference
Medical Mutual 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.
| Payer name | Medical MutualSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | OH, WISource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | 29076Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 29076Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 29076Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 29076Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 29076Source: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 29076Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | 29076Source: 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: Medical Mutual. 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: MEDICAL MUTUAL. 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: Medical Mutual. 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.
Payer contact directory
Medical Mutual phone and fax numbers
Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.
- Eligibility / benefits phone
- (800) 362-1279MEDICAL MUTUAL
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(800) 279-6772 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(800) 362-1279 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Medical Care, Pharmacy, Vision (Optometry), Medical Care, Vision (Optometry), Pharmacy, Vision (Optometry) |
| phone(800) 367-3762 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone+1 (800) 382-5729 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(800) 417-1961 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Pharmacy |
| phone(800) 457-4726 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(800) 654-9106 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(800) 852-1091 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Mental Health |
| phone(866) 326-7811 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(877) 304-0761 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(888) 876-2756 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
Phone and fax numbers sourced directly from the payer response