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An official website
© State of Utah
Main Menu
    • Apply for Medicaid
    • Apply for Baby Your Baby
    • Cómo y Dónde Pedir la Asistencia Médica
    • Members Home
    • Additional Information
    • Language Services
    • Nondiscrimination Policy
    • Programs and Services
    • Providers
    • Resources
    • MyBenefits Login
    • Medicaid Member Guide
    • Virtual Meeting Schedule
    • Providers Home
    • PRISM Info
    • PRISM Portal Access
    • Become a Medicaid Provider
    • Claims
    • Coverage and Reimbursement
    • Managed Care
    • Medicaid Pharmacy Program
    • Patient Eligibility Verification
    • Presumptive Eligibility Portal Access
    • Prior Authorization
    • Provider Resources and Information
    • Provider Training
    • Programs Home
    • Adult Expansion Medicaid
    • Autism Related Services
    • Baby Your Baby
    • Buyout Program
    • Children’s Health Insurance Program
    • Early and Periodic Screening, Diagnostic and Treatment
    • Living Well with Chronic Conditions Program
    • Medicaid for Long-Term Care and Waiver Programs
    • Presumptive Eligibility
      • Restriction Program Overview
      • Spenddown Program (Medically Needy)
    • Summary of All Medicaid Programs
    • Targeted Adult Medicaid Program
    • Tobacco Cessation Program
    • Utah's Premium Partnership for Health Insurance
    • Justice-Involved Program
    • Administration Home
    • UTAH’S MEDICAID REFORM 1115 DEMONSTRATION
    • Boards and Committees
    • HIPAA
    • Hearings
    • Medicaid Expansion
    • Medicaid State Plan
    • Nondiscrimination Policy
    • PRISM Info
    • Publications
    • Reporting Fraud
    • Unwinding Medicaid Continuous Eligibility
  • ESPAÑOL
end of mobile content form

Main Menu

    • Apply for Medicaid
    • Apply for Baby Your Baby
    • Cómo y Dónde Pedir la Asistencia Médica
    • Members Home
    • Additional Information
    • Language Services
    • Nondiscrimination Policy
    • Programs and Services
    • Providers
    • Resources
    • MyBenefits Login
    • Medicaid Member Guide
    • Virtual Meeting Schedule
    • Providers Home
    • PRISM Info
    • PRISM Portal Access
    • Become a Medicaid Provider
    • Claims
    • Coverage and Reimbursement
    • Managed Care
    • Medicaid Pharmacy Program
    • Patient Eligibility Verification
    • Presumptive Eligibility Portal Access
    • Prior Authorization
    • Provider Resources and Information
    • Provider Training
    • Programs Home
    • Adult Expansion Medicaid
    • Autism Related Services
    • Baby Your Baby
    • Buyout Program
    • Children’s Health Insurance Program
    • Early and Periodic Screening, Diagnostic and Treatment
    • Living Well with Chronic Conditions Program
    • Medicaid for Long-Term Care and Waiver Programs
    • Presumptive Eligibility
      • Restriction Program Overview
      • Spenddown Program (Medically Needy)
    • Summary of All Medicaid Programs
    • Targeted Adult Medicaid Program
    • Tobacco Cessation Program
    • Utah's Premium Partnership for Health Insurance
    • Justice-Involved Program
    • Administration Home
    • UTAH’S MEDICAID REFORM 1115 DEMONSTRATION
    • Boards and Committees
    • HIPAA
    • Hearings
    • Medicaid Expansion
    • Medicaid State Plan
    • Nondiscrimination Policy
    • PRISM Info
    • Publications
    • Reporting Fraud
    • Unwinding Medicaid Continuous Eligibility
  • ESPAÑOL
Search

Submit Enrollment Application (2 minutes)

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Submit Enrollment Application (2 minutes)

Upload Documents (4 minutes)

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Upload Documents (4 minutes)

Complete Enrollment Checklist (3 minutes)

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Complete Enrollment Checklist (3 minutes)

Add Payment Details (3 minutes)

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Add Payment Details (3 minutes)

835/ERA Enrollment Form (5 minutes)

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835/ERA Enrollment Form (5 minutes)

Associate MCO Plan (3 minutes)

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Associate MCO Plan (3 minutes)

Associate Billing Provider (4 minutes)

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Associate Billing Provider (4 minutes)

Associate Billing Agent (7 minutes)

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Associate Billing Agent (7 minutes)

Add Mode of Claim Submission (6 minutes)

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Add Mode of Claim Submission (6 minutes)

Add Additional Information (5 minutes)

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Add Additional Information (5 minutes)

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PRISM Quick Links

PRISM Quick Links

PRISM Home PRISM Provider Training PRISM Provider Training Calendar PRISM FAQs Facilitator and User Guides for Training Contact PRISM PRISM Provider Account Administrator Lookup

Provider Quick Links

Provider Quick Links

Eligibility Lookup Tool Coverage and Reimbursement Lookup Tool Physician Enhancement Attestation Criteria HIT Incentive Payment Program Find a Health Care Provider Qualifying Clinical Trials and Medicaid FAQs

HIPAA Quick Links

HIPAA Quick Links

HIPAA for Members Notice of Privacy Practices Forms Rules and Regulations HIPAA for Providers Notice of Privacy Practices Provider EDI Enrollment Provider Companion Guides Health Care Code Lists Rules and Regulations Resources

LTC Menu

LTC Menu

Utah Waivers Home Acquired Brain Injury Waiver Aging Waiver Community Supports Waiver Community Transitions Home ICF Transition Program Medicaid Autism Waiver Medically Complex Children’s Waiver New Choices Waiver Physical Disabilities Waiver Technology Dependent Waiver EPAS Program HCBS Transition Planning (Settings Rule) Health Transportation Payment Electronic Visit Verification

UPP Quick Links

UPP Quick Links

UPP Home What's UPP? How to Apply FAQs Resources Español Contact Us

Training Quick Links

Training Quick Links

PRISM Home PRISM Provider Training Eligibility Lookup Tool & Medicaid Member Card Training Provider Enrollment Training

MAC Quick Links

MAC Quicklinks

MAC Home Current Members By Laws 2023 Minutes 2024 Minutes 2025 Minutes

Pharmacy Quick Links

Pharmacy Quick Links

Preferred Drug List P&T Committee Prior Authorization Drug Utilization Review Board Drug Utilization Review (DUR) Program Medication Therapy Management Services

BAC Quicklinks

Boards and Committees Bylaws 2024 Meeting Minutes

Follow us online

Image
Department of Health and Human Services opens in a new tab
Cannon Health Building
288 North 1460 West
Salt Lake City, UT
84116
Contact Us
 
For eligibility questions or concerns:
1-866-435-7414
For other questions:
1-866-608-9422
 
External information disclaimer opens in a new tab

Navigation Menu

  • Apply
    • Apply for Medicaid
    • Apply for Baby Your Baby
    • Cómo y Dónde Pedir la Asistencia Médica
  • Members
    • Members Home
    • Additional Information
    • Language Services
    • Nondiscrimination Policy
    • Programs and Services
    • Providers
    • Resources
    • MyBenefits Login
    • Medicaid Member Guide
    • Virtual Meeting Schedule
  • Providers
    • Providers Home
    • PRISM Info
    • PRISM Portal Access
    • Become a Medicaid Provider
    • Claims
    • Coverage and Reimbursement
    • Managed Care
    • Medicaid Pharmacy Program
    • Patient Eligibility Verification
    • Presumptive Eligibility Portal Access
    • Prior Authorization
    • Provider Resources and Information
    • Provider Training
  • Programs
    • Programs Home
    • Adult Expansion Medicaid
    • Autism Related Services
    • Baby Your Baby
    • Buyout Program
    • Children’s Health Insurance Program
    • Early and Periodic Screening, Diagnostic and Treatment
    • Living Well with Chronic Conditions Program
    • Medicaid for Long-Term Care and Waiver Programs
    • Presumptive Eligibility
    • Restriction Program
      • Spenddown Program (Medically Needy)
    • Summary of All Medicaid Programs
    • Targeted Adult Medicaid Program
    • Tobacco Cessation Program
    • Utah’s Premium Partnership for Health Insurance
    • Justice-Involved Program
  • Administration
    • Administration Home
    • UTAH’S MEDICAID REFORM 1115 DEMONSTRATION
    • Boards and Committees
    • HIPAA
    • Hearings
    • Medicaid Expansion
    • Medicaid State Plan
    • Nondiscrimination Policy
    • PRISM Info
    • Publications
    • Reporting Fraud
    • Unwinding Medicaid Continuous Eligibility
  • ESPAÑOL

Resources

211Utah - United Way opens in a new tab
Safe UT opens in a new tab
Utah Domestic Violence Coalition opens in a new tab
988 Suicide and Crisis Lifeline opens in a new tab
Medicaid A-Z opens in a new tab

Hotlines

Abuse/Neglect of Seniors and Adults with Disabilities opens in a new tab
1-800-371-7897

Child Abuse/Neglect
1-855-323-DCFS(3237)

Crisis Line & Mobile Outreach Team
1-801-587-3000

National Suicide Prevention Lifeline opens in a new tab
1-800-273-TALK(8255)

Sexual Violence Crisis Line
1-888-421-1100

Utah Domestic Violence opens in a new tab
1-800-897-LINK(5465)

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