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Medica will soon transition to new vendors that will handle claims and other related services for Individual and Family Business (IFB) and Nebraska Farm Bureau members, including Medica membership administered using payer ID 12422. To avoid possible claim-submission issues related to this membership, providers should work with their claims clearinghouse to ensure they are connected with the vendor Availity by November 1, 2020. Providers will also need to register with the vendor InstaMed to avoid any electronic claim-payment disruption for this membership. 

Providers can start relying on these vendors beginning in November 2020 for the following services:

• Payment and PRA services will be handled by InstaMed. This includes provider remittance advices (PRAs), paper and electronic Explanations of Benefits (EOBs), electronic funds transfer (EFT), and paper check claims payments. 
• Electronic data interchange (EDI) transactions will be handled by Availity. This includes electronic claim submission (837 transaction), eligibility and benefit verification (270/271 transactions), and claim status inquiry (276/277 transactions). 

It is important for Medica network providers to sign up to use these vendors prior to November 2020, if they have not already done so. To help with this process, InstaMed is reaching out to Medica’s network providers to make sure they are ready for the EFT/PRA transition to InstaMed, while Medica and Availity are working with clearinghouses and leased networks to prepare for the EDI transition to Availity.

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