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Payer Directory
How to check Medica Health Plan Solutions eligibility
A portal or phone check takes a front-desk staffer 10–15 minutes per patient. Medica Health Plan Solutions has no eligibility API — so instead of your staff doing that, our screen agent runs the portal check for you, on your schedule.
Payer ID
88090Screen agent · setup requiredCommercialThree ways to verify Medica Health Plan Solutions coverage
- Payer portal — free, but one patient at a time and 10–15 minutes each with logins.
- Phone (IVR) — hold times vary; no written record for the chart.
- Automated 270/271 check — full benefit detail in seconds, batched for the whole schedule, from $0.50 per check.
Medica Health Plan Solutions at a glance
What billers need before running a check.
Payer ID
88090Also known as 41154, 7196
Real-time eligibility
Via screen agent
Medica Health Plan Solutions has no eligibility API, so our screen agent runs the portal check for you on your schedule. Setup required.
Coverage
medical
Commercial
Operating area
Florida, Georgia
Payer website
partner.medica.comSupported transactions
What can be exchanged electronically with Medica Health Plan Solutions today.
| Transaction | Status |
|---|---|
Eligibility (270/271) Real-time benefit and coverage checks | NOT AVAILABLE |
Claim status (276/277) Where a submitted claim stands | NOT AVAILABLE |
Professional claims (837P) Physician and outpatient claims | SUPPORTED |
Institutional claims (837I) Facility claims | SUPPORTED |
Dental claims (837D) Dental claims | NOT AVAILABLE |
Remittance (835 ERA) Electronic remittance advice | NOT AVAILABLE |
Coordination of benefits Secondary-payer routing | NOT AVAILABLE |
Claim attachments (275) Supporting documentation | NOT AVAILABLE |
Portal vs. phone vs. automated
The same verification, three ways.
| Payer portal | Phone / IVR | Automated check | |
|---|---|---|---|
| Time per patient | 10–15 min | 15–30 min | Seconds |
| Cost per check | ~$7.97 staff time* | ~$7.97+ staff time* | from $0.50 |
| Record for the chart | Screenshot | None | Full audit trail |
| Whole-day schedule | One at a time | One at a time | Batched overnight |
*CAQH Index benchmark for a manual eligibility verification.
Frequently asked questions
What is the payer ID for Medica Health Plan Solutions?+–
Medica Health Plan Solutions uses payer ID 88090. It also appears as 41154, 7196 in some systems.
Does Medica Health Plan Solutions support real-time eligibility verification?+–
Medica Health Plan Solutions has no eligibility API, so there is no 270/271 transaction to send. Checks still run automatically: our screen agent performs the portal check for you on your schedule, rather than a staff member doing it per patient. Setup is required. Claims can be submitted electronically.
How long does a Medica Health Plan Solutions eligibility check take?+–
A portal check takes 10–15 minutes of staff time per patient. A screen agent runs the same check without occupying anyone — scheduled ahead of the day's appointments, so results are waiting rather than being fetched one patient at a time.
Run your first Medica Health Plan Solutions eligibility check
From $0.50 per check, pay-as-you-go. No contract, no implementation project.
Billing more than Medica Health Plan Solutions? — upload it and see which of your payers run automatically.
65%
fewer denials at Valley Diabetes & Obesity
90%
of eligibility checks fully automated
$107–149K
annual savings, small specialty practice
24 mo
in production
