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Provider Training

The Medica Provider College offers online training on-demand and live webinars for our providers on various administrative topics. We invite all business office personnel throughout the Medica service area to participate. These trainings are broken into the following categories:

Classes

Classes are delivered via webinar and include time for you to ask questions. A live class is offered at least once a month on assorted topics.

View and Register for upcoming live trainings

We also post PDF versions of these classes, along with session recordings. They are typically about 30 minutes to 1 hour 30 minutes.

 

Claim appeals and adjustments are an important tool to ensure proper claims payment! This webinar will review the process for submitting appeals, adjustments and supporting documentation to Medica.

We'll focus on:

  • The different avenues for submission, and when each is appropriate
  • When appeals and adjustment requests are appropriate
  • Where to find the necessary forms on Medica.com
  • Tips for making sure that your appeal or adjustment request contains the information that supports the desired outcome in an accessible format
  • The options available if you disagree with a decision on an appeal or adjustment request

Appeal Adjustment and Record Submission Training (PDF)

Understanding all three components of a clean claim — submission, process and output — is important to ensure proper payment! This webinar will review all three in order to help you understand how they work together to facilitate the proper processing of claims.

We'll focus on:

  • Submission policies and requirements
  • 837P and 837I electronic transactions
  • Provider remittance advices (PRAs)
  • Common denial reasons
  • How to request claim adjustments and appeals

Life of a Claim Training (PDF)

This class will give an overview of all products that Medica has to offer for the 2022 plan year and where they are available, along with resources to determine eligibility, coverage guidelines and other valuable plan details that help ensure a seamless overall experience for providers when working with Medica. Note that trainings are categorized by location- for Minnesota providers vs. providers in all other states- so make sure to sign up for a session that's appropriate.

Product Overview and Resources for 2022

Having resources at your fingertips is a great way to save you time! We routinely update our provider resources. This webinar will walk you through our self-service options, including resources on medica.com.

We'll focus on:

  • Determining member eligibility
  • Verifying if utilization management and reimbursement policies apply to services being billed
  • Verifying how a claim processed
  • Next steps for claims (e.g. appeals or adjustments)

Navigating Provider Resources (PDF)

Medica Prime Solution® is Medica's cost-sharing plan with Medicare that continues to steadily gain membership. This training will review details of how this Medicare Cost product works, where it will be offered for the 2022 plan year, and how it compares to other Medicare products offered by Medica. Also covered in this training: valuable resources available on Medica.com that can be used to ensure appropriate billing practices and claim processing for this product.

Register for a Provider Training Webinar

Prime Solution: Medica's Cost Plan for Medicare Members (MP4)

This training will walk providers through requirements as well as tools and services available to assist with billing along with an overview of housing stabilization benefits; getting set up as a EW or housing stabilization provider; role of the care coordinator and role of Medica's Provider Service Center; how to obtain an authorization; the claims submission process and what to do if a claim is not processed as expected.

Set-up and Billing for EW and HSS Providers (PDF)

In this class, you will learn how to utilize Medica’s new tool called “SympliSend” for online record submissions related to claim denials. This new functionality will be available as an electronic alternative to faxing or mailing claim documentation related to payer ID 94265. SympliSend will allow for more efficient response times with appeals and claim adjustments.

Additional E-Learnings

e-Learnings are interactive trainings on a range of provider topics that take about 20-30 minutes to complete. 

Micro-Trainings

Micro-trainings are quick 5-15 minute videos with 'how to' instructions on various Medica processes.

Cultural Competency

Culture influences an individual’s health and mental health beliefs, practices, behaviors, and even the outcomes of interventions.

Learn more about how Medica supports cultural competency

Cultural Competency Training 2020 (works best using Google Chrome browser)

Medicaid ADA Questionnaire 2022

Non Medicaid ADA Questionnaire 2022

Send Us Your Feedback

Is there something you would like to learn more about? We're always working to expand our educational offerings. Send an email to let us know what you'd like to learn more about.

Email Provider College

 


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