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Individuals & Families Medical Dental Vision Short-Term Accident and Critical Illness Life

Medicare Medicare Advantage Plans with Prescription Drug Medicare Supplement Insurance Plans Find the Plan that Fits Your Needs

Employers Health Life and Disability Dental Vision Accident, Critical Illness and Hospital Indemnity Consumer-driven Health Products Federal Employees Health Benefits Program

Members

Forms

FAQs

Mobile App

Providers

In the News

Policies and Standards Accessibility Standards Clinical Practice Guidelines Corporate Medical Policies Corporate Reimbursement Policies Medical Drug Management Medical Necessity Criteria and Clinical Review Guidelines Prescription Drug Resources Prior Approval and Investigational Services

Resources Chronic Condition Management Program Claims Edit System Clinical Supply Materials Continuity and Coordination of Care Credentialing Cultural Competency Resources EFT and ERA First tier, Downstream or Related Entities Forms Healthcare Technology Assessment HEDIS Documentation Reference Guide Medical Mutual Service Accounts Outpatient Ambulatory Surgery Classification Groups

Brokers

Why Work with Us

Broker Tools

Meet Our Account Managers

About Medical Mutual

Resources

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Healthcare Technology Assessment

A healthcare technology assessment review process that incorporates the development of Corporate Medical Policies (CMP), including the evaluation of new and emerging technology for consideration of future policy inclusion.

HEDIS Documentation Reference Guide

Guidelines and requirements for medical record documentation.

MedCommunity Resources

MedCommunity is our new clinical management provider portal for the submission of inpatient admissions and continued stay requests. It also facilitates collaborative discharge planning and the exchange of clinical information.

Medical Mutual Service Accounts

Medical Mutual provides network services for various accounts including self-insured groups, Health and Welfare Funds, third-party administrators and other insurance companies. View a list of service accounts.

First tier, Downstream or Related Entities

Forms

Easily view all of Medical Mutual's provider forms in one place.

Chronic Condition Management Program

Our Chronic Condition Management Program offera additional support to our members.

Claims Edit System

Access our claims edit system.

Clinical Supply Materials

Views PDFs of helpful health and wellness materials.

Continuity and Coordination of Care

Patient Summary Forms are available for providers to help facilitate coordination of care.

Credentialing

Explore our credentialing process and learn how to become an in-network provider with Medical Mutual.

Cultural Competency Resources

Access educational resources to help in your efforts to provide culturally competent care.

EFT and ERA

Learn more about using Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) to simplify payments.

Outpatient Ambulatory Surgery Classification Groups

View our outpatient ambulatory surgery classification (ASC) group methodology.