Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Medica before sending sensitive documents. FaxFlow is not affiliated with this organization.
Medica fax number
(952) 992-3198
Customer Service
Used for: Medical records request / authorization to disclose protected health information (PHI)
Fax destination details
- Department
- Customer Service
- Purpose
- Medical records request / authorization to disclose protected health information (PHI)
- Form
- Authorization to Disclose Protected Health Information — Authorization to Disclose Protected Health Information
- Address
- 401 Carlson Parkway, Minnetonka, MN 55305, United States
- Voice phone
- 952-992-2900
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Complete the Member Information section, specify the recipient, sign and date, and return to Medica Customer Service as shown on the form. Include any necessary identifiers.
Review official form instructionsSources and verification
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