Find out if a patient is covered by Medicaid or PCN, the months of eligibility, co-payment/co-insurance, and in which ACO the patient is enrolled.
For questions regarding Utah Medicaid Fee for Service Prior Authorizations, contact us:
By Phone (M, T, W, F 8am-5pm, Thursday 11am-5pm)
- In the Salt Lake City area, call (801) 538-6155
- In Utah, Idaho, Wyoming, Colorado, New Mexico, Arizona and Nevada, call toll-free (800) 662-9651
- From all other states, call (801) 538-6155
- For Prior Authorizations choose option 3, 3 and then the appropriate program
See page 3 of the Prior Authorization Request Form
- Use ANSI 276/277 or call Medicaid Information: 1-800-662-9651
- Medicaid Crossover Claims: SECTION 1, Chapter 11 - 6, of the Utah Medicaid Provider Manual.
Hearings for Providers and Peer Review
When a Medicaid member, provider, or other interested party is dissatisfied with an action taken by Utah Medicaid, a hearing may be requested by filing a hearing request with the Office of Formal Hearings to appeal the action. For more information or to contact the Office of Formal Hearings, click here.
- Procedures for Provider Hearing: SECTION 1, Chapter 6 - 14, of the Utah Medicaid Provider Manual
- Procedures for Peer Review: SECTION 1, Chapter 7 - 1, of the Utah Medicaid Provider Manual