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Utah Medicaid Eligibility Information Systems
For use by Utah Medicaid Providers ONLY

Medicaid has three information systems available for providers to verify if their patients are eligible for Medicaid: 

  • Eligibility Lookup Tool - a website to electronically view a member's Medicaid eligibility 
  • AccessNow - a touchtone telephone eligibility line
  • ANSI 270 and the ANSI 271 - an indirect connection to the Medicaid computer system

Eligibility Lookup Tool

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.  In addition, the Eligibility Lookup Tool can be used to verify Primary Care Network (PCN) and Children's Health Insurance Program (CHIP) eligibility.  Training materials on how to use the Eligibility Lookup Tool are available here.

AccessNow

Use a touchtone telephone to operate AccessNow.  It provides information on patient eligibility, patient restrictions, other insurance coverage, MCP enrollment, and Primary Care Provider information, when applicable.   Instructions for use of AccessNow are available from Medicaid.

  • In the Salt Lake City area, call: (801) 538-6155
  • In Utah, Idaho, Wyoming, Colorado, New Mexico, Arizona, and Nevada, call: Toll-free 1-800-662-9651
  • From other states, call: (801) 538-6155

ANSI 270 and ANSI 271

These two HIPAA compliant transactions provide member eligibility and claim status for providers who are members of the Utah Health Information Network (UHIN).  To use these tools:
  • Obtain a Trading Partner Number (TPN) from UHIN or call (801) 466-7705.
  • Use the free software from UHIN (or any HIPAA compliant software) to transmit your request.
  • After two hours use your software to retrieve the Medicaid response to your query.

Check out these links for instructions and more information about the Eligibility Lookup ToolAccessNow, and the ANSI 270 and ANSI 271.