Payer ID 71890: Medica Health Plan Solutions

Electronic transactions for payer ID 71890

What Medica Health Plan Solutions accepts electronically under payer ID 71890, and which transactions need provider enrollment before they work, as listed in the Stedi payer network directory.

Support is per clearinghouse connection: a transaction listed as not supported here may still work through another clearinghouse or the payer's portal. Enrollment, where required, is done once per provider and clearinghouse.

Where payer ID 71890 goes on a claim

On an electronic professional (837P) or institutional (837I) claim, the payer is identified in loop 2010BB, the payer name loop. The NM1 segment there carries entity identifier code PR (payer), the payer's name, the qualifier PI in NM108, and the payer ID itself in NM109:

NM1*PR*2*MEDICA HEALTH PLAN SOLUTIONS*****PI*71890~

The same NM1*PR structure names the payer in loop 2100A of 270 eligibility and 276 claim status requests. Many clearinghouses use one payer ID for claims, eligibility, and claim status, but some assign a separate ID per transaction, so check the payer list for each transaction type you send.

Before you submit to payer ID 71890

1. 1

   Read the member's ID card

   The claims payer ID or claims address printed on the card is the most specific source for that member's plan. Where it differs from a directory listing, the card generally reflects how that plan wants claims sent.

2. 2

   Check whether a third-party administrator runs the plan

   Self-funded employer plans route claims to their administrator's payer ID, which is often different from the network or carrier name printed on the card.

3. 3

   Confirm the ID on your clearinghouse's payer list

   Payer IDs are assigned per clearinghouse. Large national payers tend to use the same ID nearly everywhere; regional plans and administrators often do not. Search your clearinghouse's list for 71890 and confirm it maps to Medica Health Plan Solutions.

4. 4

   Watch the acknowledgments, not just the remittance

   A wrong payer ID fails at the clearinghouse or on the 277CA claim acknowledgment, not as a denial on the 835. A rejected claim was never received by the payer, so the timely filing clock keeps running until a corrected claim is accepted.

Other payer IDs and plan names for Medica Health Plan Solutions

Stedi's payer network also accepts these 3 IDs for Medica Health Plan Solutions. If your clearinghouse, an older payer list, or a remittance shows one of them instead of 71890, it most likely routes to the same payer - confirm on your clearinghouse's payer list before you submit.

• 7859
• 11131
• MHSRT

Medica Health Plan Solutions billing reference

• Medica Health Plan Solutions writes medical, vision coverage nationally. Rette indexes 289 Medica Health Plan Solutions policy documents - coverage criteria, prior authorization requirements, and billing guidelines.

  Medica Health Plan Solutions timely filing, prior auth, and appeals

Payer ID 71890 questions

Which insurance company uses payer ID 71890?

Payer ID 71890 belongs to Medica Health Plan Solutions in the Stedi payer network directory. Payer IDs are assigned per clearinghouse, so check 71890 against your own clearinghouse's payer list before submitting.

What is the Medica Health Plan Solutions payer ID?

The Medica Health Plan Solutions electronic payer ID is 71890. It goes in loop 2010BB of the 837 claim. Payer IDs are assigned per clearinghouse, so confirm 71890 against your own clearinghouse's payer list before relying on it.

Where do I enter payer ID 71890 on an 837 claim?

In loop 2010BB, the payer name loop: the NM1 segment with entity identifier PR, qualifier PI in NM108, and 71890 in NM109. The same NM1*PR structure identifies the payer in loop 2100A of 270 eligibility and 276 claim status requests, though some clearinghouses assign a different payer ID for those transactions.

Can I check eligibility electronically with payer ID 71890?

Yes. Stedi's payer network lists real-time eligibility and benefits checks (270/271) for Medica Health Plan Solutions under payer ID 71890, with no enrollment step.

Do I need to enroll to receive ERAs from payer ID 71890?

Yes. Stedi's payer network lists 835 electronic remittance advice from Medica Health Plan Solutions as requiring enrollment, which typically approved within hours. ERAs are enrolled per clearinghouse, so enrolling with a new clearinghouse usually moves your 835s to it.

Does Medica Health Plan Solutions use any payer ID other than 71890?

Stedi's payer network also accepts 7859, 11131 and MHSRT for Medica Health Plan Solutions. Clearinghouses and older payer lists often show one of these instead of 71890; if yours does, it most likely routes to the same payer, but confirm on your clearinghouse's payer list before you submit.

Payer IDs for related payers