Medica Individual and Family
dentalmedical
Summary
Medica Individual and Family is a dental and medical payer operating in 8 states. Claims route under payer ID 12422, with 4 alternate IDs in use across clearinghouses. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and activates within hours.
At a glance
- Payer ID
12422Also seen as 11171, 6799, MEDIFB, Z95382- Also known as
- Medica2, Medica2 IFB
- Service area
- IA, KS, MN, MO, NE, ND, OK, WI
Clearinghouse transaction setup
Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.
| Transaction | Enrollment | Typical setup |
|---|---|---|
| Eligibility checks (270/271) | Not required | Immediate |
| Claim status (276/277) | Not required | Immediate |
| Professional claims (837P) | Not required | Immediate |
| Institutional claims (837I) | Not required | Immediate |
| ERA / remittance (835) | Required | Same day |
Common questions
- What is the payer ID for Medica Individual and Family?
- The payer ID for Medica Individual and Family is 12422. Alternate IDs seen across clearinghouses include 11171, 6799, MEDIFB, Z95382.
- Does Medica Individual and Family require ERA enrollment?
- Yes. Medica Individual and Family requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes a few hours.
- What states does Medica Individual and Family cover?
- Medica Individual and Family operates in IA, KS, MN, MO, NE, ND, OK, WI. Coverage can differ by plan and product line, so confirm the specific plan before you file.
- What types of coverage does Medica Individual and Family offer?
- Medica Individual and Family covers dental and medical.
- Can I submit claims to Medica Individual and Family electronically?
- Yes. Medica Individual and Family is reachable through clearinghouses for eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance. Electronic claims are supported for professional (837P) and institutional (837I).
Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.