MEMIC
MEMIC is a payer organization operating in Maine. For an ASC, what matters isn't the logo. It's how MEMIC pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete MEMIC analysis
Tell us where to send it. Our team will prepare an analysis of MEMIC covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How MEMIC pays
See how MEMIC reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
MEMIC's presence spans Maine. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for MEMIC and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive MEMIC's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking MEMIC up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with MEMIC
- Payer ID
- 11030 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to MEMIC through a clearinghouse.
- Eligibility verification
- Coverage and benefits for MEMIC members are verified before the date of service, through a clearinghouse using payer ID 11030or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with MEMIC directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of MEMIC the way it pays.
- What is MEMIC's payer ID?
- MEMIC's electronic payer ID is 11030. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to MEMIC through a clearinghouse.
- How do ASCs verify eligibility for MEMIC members?
- Eligibility and benefits for MEMIC members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 11030) or through the payer's provider portal.
- Does MEMIC require prior authorization for ASC procedures?
- Prior-authorization requirements for MEMIC are set per plan and per procedure. Confirm whether an authorization is required with MEMIC directly before the date of service.
- What type of payer is MEMIC?
- MEMIC is a payer organization operating in Maine.
- How does MEMIC compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where MEMIC pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is MEMIC paying my ASC below market?
- Put your own MEMIC contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.