MDM Insurance

Providers Portal

Provider Application Forms

MDM Insurance Services Inc. is an Administrator and Adjudicator of Employee Benefit Plans for Corporations, and offers a pay direct drug card to all of our clients.

Please complete the applicable Provider Number Request Form and return to our office along with a VOID cheque for processing. If we receive the completed form in our office before 4:00 pm. EST, you will be able to begin processing claims electronically the following day.

The MDM Guard Card works just like any other pay direct drug card, and has been in existence since 1996. For electronic processing of prescriptions, you will require the 11 digit client ID number that is found on the front of the MDM Guard Card. This is the number that you will enter into the 'Client ID" field. MDM does not require a carrier number or a group policy number, however should your software require an entry in that field; enter 1000.

You may need to contact your software provider in order to confirm which processing code they have assigned to MDM.

We pay our pharmacies by direct deposit on a bi-weekly basis, every second Tuesday of the month.

Should you require any further information, or should you wish us to walk you through the processing of your first MDM claim, please do not hesitate to contact our office.

Please click on your province to the right to print your Provider Number Request Form.

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