PRISM Provider Account Administrator Lookup

If your provider/facility is not listed, or if the administrator is no longer with your organization, please complete the user access request form opens in a new tab and email it to providerenroll@utah.gov.

Otherwise, please complete the user access request form opens in a new tab in the link below and send it to your administrator.

When completing the user access request form, you will need to specify which profile(s) you want for PRISM. Use the following table to determine which profile(s) you need.

Function

Profile

Area

Modify provider information, submit new enrollment, and disenrollment requests.

EXT Provider Credentialing Specialist

Provider Enrollment

Add or modify EDI information including submission method, contact, and trading partner. User can submit changes to DOH.

EXT Provider EDI Team

Provider Enrollment

View only access, cannot make modifications.

EXT Provider View Only

Provider Enrollment

View, upload and submit files to DOH.

EXT Provider Upload Files

Provider Enrollment

View HIPAA Response/Acknowledgements and upload HIPAA files. View TPN Information.

EXT EDI Analyst

Provider Enrollment

Submit claims

Claims Submitter - Provider

Claims

Inquire on claims, including pharmacy claims.

Claims Inqury - Provider

Claims

Submit claims, inquire on claims including pharmacy claims, and adjust/void claims.

Claims Processor - Provider

Claims

Create a PA or modify a PA that is not in a final status.

EXT PA Provider Access

Prior Authorization

Create a PA or modify a PA that is not in a final status. Create an Admission Record for Nursing Facility and Hospice.

EXT Admission/PA Provider Access

Prior Authorization

Member eligibility inquiry

EXT Member Provider Access

Member Eligibility

Create TPL lead, View member TPL information

EXT TPL Provider Access

TPL

Access EHR incentive information link and the eMIPP system to update/submit eligibility, appeals, audits and payment information.

Provider EHR Incentive Specialist

EHR

Complete new provider enrollment or validate converted provider data. Approve any new users for the Provider’s domain. Management for the organization, including uploading scanned user agreements, assigning user profiles and managing/terminating user access. Profile does not have access to EHR Incentives.

EXT Provider Account Administrator

Security

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