Optum Facility Credentialing & Network Participation
Medica is a nonprofit health plan serving over 1.5 million members across the Upper Midwest. They focus on affordable healthcare solutions with strong presence in both commercial and government programs.
Strong regional presence in Minnesota with 20% market share, expanding across Upper Midwest markets.
Everything you need to know about contracting with Medica for behavioral health services
Coverage details & levels of care
Medica provides comprehensive behavioral health benefits through Medica Behavioral Health (MBH), administered by Optum, with focus on integrated care, prevention, and community-based services across their Midwest markets.
Behavioral Health Manager
Optum
All treatment settings accepted by Medica
What sets Medica apart
Required credentials for network participation
Prior Authorization
Medical Necessity Criteria
Uses nationally recognized criteria through Optum - likely InterQual or MCG for mental health, ASAM for substance use
Payment and billing information
Current network needs and priority areas for facility contracting with Medica
Current Network Needs
Adolescent residential treatment centers, eating disorder specialty programs, co-occurring disorder treatment facilities, rural area coverage, specialized trauma programs
High-demand service areas and locations
Medica provides coverage in 5 states across the United States
5 states nationwide
Corporate Headquarters
Minnetonka, Minnesota
Our team specializes in Medica contracting for behavioral health facilities. We'll help you secure competitive rates and streamline your credentialing process.
Achieve significantly better reimbursement through expert negotiation
Reduce credentialing timeline from months to weeks
CAQH, state licensing, and accreditation guidance
Your personal contracting specialist throughout the process
500+
Facilities Contracted
45
Days Avg. Timeline
98%
Success Rate
50
States Covered