What is MDHIN?

MDHIN is a Membership Payer

The Medical Health Inclusive Network (MDHIN) is a payer that manages membership-based access to routine and preventive care through two delivery tracks: RxDirectCare (pharmacy concierge) and MDDPC (physician direct primary care). We are not insurance.

Why “Inclusive”?

  • Start care where people live and shop—community pharmacies and virtual options.
  • Serve individuals, families, employers, unions, ACOs, and provider groups.
  • Works alongside existing insurance without disrupting attribution.

What Members Get

  • Concierge access & navigation via RxDirectCare or MDDPC
  • Same-day pharmacy care via ConnectRxCare
  • Transparent monthly pricing (no copays or deductibles)
  • Options for POCT and chronic care support by tier

Claims & Eligibility

  • Pharmacies: submit encounters to MDHIN via BIN/PCN using MDHIN groups/tier codes and pseudo-NDC/service codes.
  • Providers: submit via 837/835 using the MDHIN payer code (or collaborate through ConnectHIN).
  • Each claim includes a unique Visit ID and standard coding (e.g., 99202–99215, 99423; 99000 for POCT when applicable). Use Modifier 25 when multiple services occur in one encounter.
  • Eligibility is real-time; membership resets annually. PGx benefit is once per member lifetime.

Ready to join? Enroll via RxDirectCare or via MDDPC.

Coverage varies by tier and location. Eligibility resets each year; unused benefits don’t carry over.