PRISM Training

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PRISM FAQs & Guides

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Contact PRISM

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PRISM Portal Access

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Provider Training Calendar

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PRISM Provider Account Administrator Lookup

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Starting May 1, 2023, DHHS will begin issuing a new Medicaid card to replace the old Utah Department of Health (UDOH) card for newly enrolled Medicaid members. Each new Medicaid member will get their own card. Existing members will continue to use their old UDOH Medicaid card. Please accept both DHHS and UDOH Medicaid cards. Learn more in the New Medicaid Card FAQ for Providers opens in a new tab.

PRISM system downtime notifications are made in recorded messages on the customer service hotline, as well as with banner messages here on the Medicaid website, in the PRISM system, and in the UHIN system. To be notified of PRISM system downtimes by email, subscribe below.


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PRISM Project Go-Live


In April 2023, Utah Medicaid replaced the Utah Medicaid Management Information System (MMIS) with a new system called Provider Reimbursement Information System for Medicaid (PRISM). The Provider Enrollment component of PRISM was implemented in 2016 and updated in June 2020. After a soft go-live in January 2023, PRISM is now fully operational with the following components:

  • Managed Care Processes
  • Prior Authorization
  • Member Eligibility
  • Claims Adjudication
  • Claims Payments
  • Member Web Portal
  • Audit Studio (Fraud and Abuse System)

Claims Submission

With the new PRISM system, paper claims are no longer accepted. Any paper claims that are received will be securely destroyed and no longer returned to providers or their vendors.

There may be a learning curve to submitting claims for payment. To help provider offices with these changes, virtual calls have been scheduled so that providers can efficiently ask questions and get answers. Get the Provider Billing and Claims Q&A schedule.

Medicaid Ordering and Referring Provider Update

Under the 21st Century Cures Act, State Medicaid Agencies must require all Ordering, Referring, and Prescribing (ORP) providers to enroll with the state Medicaid agency as a Medicaid provider. In addition, certain Medicaid providers, such as Home Health, DME and others, are required to include an ordering/referring provider on their claim to Medicaid. If the ORP is not included and/or is not enrolled with Medicaid, states are required to deny the billing provider’s claim. For more information please see “Medicaid Ordering and Referring Provider Updates opens in a new tab”.

PRISM Provider Type, Specialty, and Subspecialty Profile Updates

To become a billing, rendering, referring, or ordering provider for Medicaid, it's crucial to identify your provider type, specialty, and subspecialty. Medicaid's PRISM system requires this information to process and pay claims accurately.

For more information on this and on how to update or submit your provider type, specialty, and subspecialty known to PRISM, please see the PRISM Provider Type, Specialty, and Subspecialty Updates form linked below.

Provider Trainings

To help providers with the system changes, new eLearning courses are available.

Helpful Resources

Detailed information about PRISM functionality, including claims submissions, can be found below:

Medicaid Information Bulletin (MIB) articles are published throughout the year with information on how PRISM will impact providers. View the PRISM related MIB articles below:

Multi-Factor Authentication

Providers will need to go through a multi-factor authentication process to access the PRISM application. Please visit the links below for additional information: