Medica Q&A
With SSM Health's 2021 agreement with Medica – an independent, non-profit health plan headquartered in Minnetonka, Minnesota, Dean Health Plan and Medica became partners. Both health plans are using their partnership to strengthen their abilities to provide high quality support for providers and members amid an ever-evolving health care environment, while maintaining their individual presence in their communities. See our Q&As to learn more about this partnership.
To reflect our relationship with Medica, we updated the Dean Health Plan logo to include a "by Medica" endorser and heart icon.
The partnership with Medica also brought WellFirst Health, a SSM Health-created health plan in Illinois, Missouri, Wisconsin, and Oklahoma, into the Medica family. To unify product offerings and streamline resources, the WellFirst Health brand was discontinued and rebranded as "Medica." This name change includes the benefit plans for Medica (formerly Dean Health Plan) employees and SSM Health employees.
Note: The Medica (formerly WellFirst Health) brand and products are different than the Medica brand and products that our partner Medica, headquartered in Minnesota, offers. Medica (formerly WellFirst Health) is sometimes referred to as Medica Central Health Plan to distinguish it from other Medica products. Access online information and resources for Medica Central. While we make progress aligning business platforms and policies with our partner Medica, Dean Health Plan providers should continue referring to Deancare.com for information.
We do not foresee changes in business locations. Both health plans remain committed to serving their communities through close partnerships with local health care providers.
For Dean Health Plan, this is the 35-plus years commitment to our local presence in southern Wisconsin and the more than 5,000 providers in our network, including SSM Health-Wisconsin providers and hospitals.
We encourage providers to reach out to Medica through their usual channels with any questions about their Medica contracts.
Dean Health Plan shares the following business platforms and systems with Medica for benefit plans under the payer ID 41822:
- Availity Essentials Provider Portal
- Availity Electronic Data Interchange (EDI) Gateway
- InstaMed payment services (remittance advice, Explanations of Payments, electronic funds transfer [EFT], and paper checks)
- New Provider Service phone number featuring expanded hours, and 24/7 self-service through the Interactive Voice Response (IVR) system
Currently, the above platforms apply to benefit plans under payer ID 41822* which are:
- IFB/ACA plans for dates of service on and after Jan. 1, 2024.
- Commercial plans in phases as groups renew, with the first renewals May 1, 2024.
Business platforms for all other payer IDs remain the same until further notice.
*Except for InstaMed which also applies to payer ID 39113.
We'll announce dates to move additional benefit plans to business platforms under payer ID 41822 in the future.
Continue to use the Dean Health Plan website for online information.* See the following resources under the "Our Medica partnership" section of the Provider Communications web page:
- Dean Health Plan Provider Quick Reference by Payer ID – Identifies resources and processes with the addition of payer ID 41822.
- Dean Health Plan's Just in Time for Providers – Latest information on preparation and processes as we transition to business platforms under payer ID 41822.
- Provider Communications – a list of communications about our partnership with Medica.
* As we align business platforms and policies with our partner Medica, Dean Health Plan providers should continue referring to Deancare.com for information.
Refer to this FAQ web page for updates. Also, go to our Provider News and Provider communications web pages to see articles and communications regarding our partnership with Medica.
Our Medica partnership places all our health plans within the Medica family which includes Dean Health Plan, Prevea360 Health Plan, and Medica (formerly WellFirst Health): The following summarize Dean Health Plan-related product changes:
- The SSM Health Employee Health Plan, previously administrated by and branded as WellFirst Health, is now branded as Medica. This is a name change only and there is no change to the provider network.
- The Medica Employee Benefit Plan product became effective Jan. 1, 2023, for Dean Health Plan employees in Wisconsin, now Medica employees. In Wisconsin, leverage the Dean Health Plan ASO provider network is the network for the SSM Health and Medica Employee Health Plans.
No, there is no change to the patients you can serve. You can only deliver care to patients enrolled in benefit plans covered under your provider contract with us.
If you have questions, contact your Provider Network Consultant. To find your assigned consultant, go to Deancare.com/providers and scroll to the bottom of the web page.
Yes, for some benefit plans. We've moved our 2024 Individual + Family Business (IFB)/Affordable Care Act (ACA) plans (both Marketplace and direct) and are transitioning Commercial plans (as groups renew) to new business platforms under payer ID 41822. As we communicated early in our partnership with Medica, both health plans anticipated using the partnership as an opportunity to align best practices and share technology.