Utah Department of Health & Human Services - Integrated Healthcare
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    • Cómo y Dónde Pedir la Asistencia Médica
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    • Become a Medicaid Provider
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    • Presumptive Eligibility Portal Access
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    • 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
    • Primary Care Network
    • Restriction Program
    • Spenddown Program (Medically Needy)
    • Summary of All Medicaid Programs
    • Targeted Adult Medicaid Program
    • Tobacco Cessation Program
    • Traditional and Non-Traditional Medicaid
    • Utah’s Premium Partnership for Health Insurance
  • Administration
    • Administration Home
    • UTAH’S MEDICAID REFORM 1115 DEMONSTRATION
    • Boards and Committees
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    • Nondiscrimination Policy
    • One-Time Projects
    • PRISM Info
    • Publications
    • Reporting Fraud
    • UAMRP (Utah Access Monitoring Review Plan)
    • Unwinding Medicaid Continuous Eligibility
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Utah Department of Health and Human Services - Integrated Healthcare

Prior Authorization

Pharmacy Criteria Forms

Medical Criteria

General PA Forms

Resident Assessment Forms

Coverage and Reimbursement Lookup Tool

Contact Us

Frequently Asked Questions

Manuals

Qualifying Clinical Trials and Medicaid FAQs

Follow us

Headquarters
Multi-Agency State Office Building
195 North 1950 West
Salt Lake City, Ut 84116

For eligibility questions or concerns:
1-866-435-7414

For other questions:
1-866-608-9422

Resources
211Utah - United Way
Safe UT

Hotlines
Abuse/Neglect of Seniors and Adults with Disabilities
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
1-800-273-TALK(8255)

Sexual Violence Crisis Line
1-888-421-1100

Utah Domestic Violence
1-800-897-LINK(5465)

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  • 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
  • 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
    • Primary Care Network
    • Restriction Program
    • Spenddown Program (Medically Needy)
    • Summary of All Medicaid Programs
    • Targeted Adult Medicaid Program
    • Tobacco Cessation Program
    • Traditional and Non-Traditional Medicaid
    • Utah’s Premium Partnership for Health Insurance
  • Administration
    • Administration Home
    • UTAH’S MEDICAID REFORM 1115 DEMONSTRATION
    • Boards and Committees
    • HIPAA
    • Hearings
    • Medicaid Expansion
    • Medicaid State Plan
    • Nondiscrimination Policy
    • One-Time Projects
    • PRISM Info
    • Publications
    • Reporting Fraud
    • UAMRP (Utah Access Monitoring Review Plan)
    • Unwinding Medicaid Continuous Eligibility
  • ESPAÑOL
  • Search