1)File Online

2)Fax: 877-877-0078
3)Mail(Claims ONLY):
PO Box 21531
Eagan, MN 55121

1)Fax:877-877-0078
2)Mail(Claims ONLY):
PO Box 21531
Eagan, MN 55121

Electronic Payor ID:73066 ALL OTHER CORRESPONDENCE,PLEASE MAIL OR FAX TO:

MedMutual Protect
PO Box 26620
Oklahoma City, Oklahoma 73126-9958
Fax: 405.254.2111 or 1.877.877.0078

	How to Submit Your Claim  A guide for submitting a claim when the service provider does not submit the claim directly.
	MedMutual Protect Claim Form  Should be filled out completely and submitted with the physician and/or hospital bill. See the Notice to Residents on page 2 of the claim form.
	Home Health Certification Claim Form Physician's Home Health Care Certification claim form, see the Notice to Residents on page 2 of the claim form. If you are resident in Texas, please download the state specific form by clicking on your state name.

Providers who send electronic transmissions directly to MedMutual Protect must enroll with clearinghouse Smart Data Solutions. To initiate enrollment of HIPAA compliant transactions sets, please contact Smart Data Solutions. You may contact them via phone at 1.855.297.4436 or by email stream.support@sdata.us.

The MedMutual Protect (policies underwritten by Reserve National Insurance Company) electronic payer ID is 73066 for Professional, Institutional and Secondary Medical claims only. Dental claims must be submitted by mail.