Patient Eligibility Verification

The Eligibility Lookup Tool is a website that allows a provider to electronically view a member’s Medicaid eligibility and plan enrollment information.  The Eligibility Lookup Tool will also tell you if the patient is restricted to a specific provider and if the patient is responsible for co-pays.

To verify your patient’s eligibility on the portal you will need the information off of the Medicaid card which includes member’s name, Medicaid ID and date of birth.  A provider must also have a Provider ID (NPI or API) known to Medicaid.

In order to be in compliance with HIPAA, we must assure that only those that have the right to this information have access.  A provider will have to register with the State of Utah by creating a Utah-ID account.  If not currently logged in, you will be redirected and prompted to log in.  If you have a Utah-ID and password, simply login to access the Eligibility Lookup Tool.  Due to security, there is a 20-minute inactivity timeout feature on the Eligibility Lookup Tool.

Click here for more information and instructions if you have not previously created a Utah-ID account. 

Eligibility Lookup Tool