Become a Medicaid Provider

Starting May 1, 2023, DHHS will begin issuing a new Medicaid card to replace the old Utah Department of Health (UDOH) card for newly enrolled Medicaid members. Each new Medicaid member will get their own card.  Existing members will continue to use their old UDOH Medicaid card. Please accept both DHHS and UDOH Medicaid cards. Learn more in the New Medicaid Card FAQ for Providers.

RETRO-ENROLLMENT FOR BILLING AND ORP PROVIDER TYPES

Utah Medicaid would like to make you aware of a temporary extension for providers requesting retro enrollment. The extension will be allowed April 3, 2023, to October 5, 2023, but is contingent upon the provider meeting all credentialing and licensing requirements for the requested retro effective date. If the provider is not licensed or credentialed for the period requested, they will be given the begin date of their license.

Ordering, Referring, Prescribing (ORP) Providers

Providers enrolling as ORP, may be granted a retro enrollment date up to 12 months from the date the provider submitted the application accurately and completely. The provider must upload a detailed justification statement to their PRISM application or modification that includes:

  • The NPI number of the provider
  • The requested retro enrollment date
  • Reason for the delay in submitting the provider’s application timely (refer to the Utah Medicaid Provider Manual Section 1, 3.1)

If the provider is approved under this option and then later submits a modification to update their applicant type to a billing provider, the modification will be subject to the seven-month time frame listed below.

Billing Providers

Providers enrolling under the umbrella of “billing” provider types, may be granted a retro enrollment date up to seven months from the date the provider submitted the application accurately and completely. The provider must upload a detailed justification statement to their PRISM application or modification that includes:

  • The NPI number of the provider
  • The requested retro enrollment date
  • Reason for the delay in submitting the provider’s application timely (refer to the Utah Medicaid Provider Manual Section 1, 3.1)

Please refer to the Medicaid Provider Enrollment Compendium for more information on retro enrollment and other provider enrollment information: MPEC

Please note the approval of a provider’s retro-enrollment request does not circumvent the federal regulation requirement

 42 CFR 447.45 timely claims payment.


Thank you for your interest in participating as a Medicaid provider. To become a Medicaid provider, you must complete the PRISM online enrollment and submit the required forms and documents.

If you do not wish to be reimbursed by Medicaid for your services but would still like to order, refer or prescribe to Medicaid members, you will still need to complete the PRISM online enrollment.

Creating a Utah ID Account

A provider will have to register with the State of Utah by creating a Utah-ID Account. If you have a Utah-ID and password, simply log in to access the PRISM Portal.  Click here for more information and instructions if you have not previously created a Utah-ID account.

Starting April 1, 2021, providers will need to go through a multi-factor authentication process to access the PRISM application. Please visit the links below for additional information:

PLEASE NOTE THAT ONLINE APPLICATIONS WILL BE PURGED AFTER 90 DAYS IF NOT COMPLETED AND SUBMITTED.

New Enrollment Application and Track Your Application

To become a Utah Medicaid Provider or to track your application click on the PRISM Portal.

For assistance on how to enroll as a new Medicaid provider, please refer to the Enrolling as a New Medicaid Provider eLearning courses. These courses describe how to enroll as a new Utah Medicaid Provider depending on the enrollment type.

If you have questions, please call Provider Enrollment at (801) 538-6155, or toll-free 1-800-662-9651 (option 3 then 4) or by email: providerenroll@utah.gov. Do not send protected health information (PHI) to this email address.

Additional Forms for Providers: