Medica Administrative Manual  >  Billing and Reimbursement > Electronic Transactions

Electronic Transactions

Log in to Electronic Transactions to perform patient service transactions such as:

• Administrative referral entry
• Admission notification
• Check claim status
• Electronic payments and statements 
• Eligibility inquiries
• Prior authorization
• Referral status, inquiry and modification
• Request a claim adjustment or appeal 

Direct contracted providers can also perform clinic administration transactions such as:

• Clinic demographic updates
• Fee schedule download and lookup
• Provider Demographic Update Online Tool (PDOT)
• Provider search 

Log in to Electronic Transactions > 

User Guides and Resources

• Electronic Billing Resources for Smaller Providers (PDF)
• Electronic Payments and Statements – How to Register (PDF)
• Electronic Transactions – Eligibility Inquiry Helpful Hints (PDF)
• Provider Portal Registration Guide for Primary and Secondary Administrators (PDF)
• User Guide for Medica Electronic Transactions (PDF)
• User Guide for Provider Demographic-Update Online Tool (PDOT) – (PDF)

Log In URLs

• Availity
• Medica Electronic Transactions
• MN E-Connect

Learn More About Electronic Transactions

Medica has several different payer ID’s, based on product and the internal platform within Medica where claims are being processed. Additionally, Medica utilizes two vendors for Electronic Data Interchange (EDI), Availity and Optum, for claim submission. For Electronic Payments & Statements (EPS), we partner with InstaMed and Optum Pay, to provide the delivery of electronic claims payments and remittance advice information.

For efficient claim submission, processing and payment, it is important to submit claims to the correct payer ID and know which vendor the payment will be coming from once processed. To determine the correct payer ID, EDI, and EPS vendor for each product, along with other valuable product guidelines, check the member ID card for the appropriate payer ID and utilize the Medica Claim Submission and Product Guidelines resource page.

If you do not have the member ID card and need to confirm the correct payer ID, you can either log in to Medica’s provider portal and check eligibility under Electronic Transactions or contact the Provider Service Center at 1 (800) 458-5512.

For issues related to electronic claim submission, error reports and other connectivity issues, Medica encourages you to work with your clearinghouse directly.  

Additional Resources:

InstaMed Online Provider Portal training
Washington Publishing website (ANSI 837 Claim submission information)
Provider Remittance Advice/Electronic Remittance Advice
Medica Products and Billing Resources e-Learning

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REV 2/2024