Provider Network Management

New Provider Application - A two-step process.

Please note: We are not accepting applications for the specialties listed below.
  • Behavioral Health Providers (in Davis, Utah, & Salt Lake Counties) – Except Psychiatry & Psychology or providers that specialize in working with children.
  • Chiropractic
  • Durable Medical Equipment / Medical Supplies
  • Home Health / Hospice / Personal Care Agencies
  • Home Infusion
  • Laboratories
  • Long–Term Acute Care Hospitals (in Davis, Salt Lake & Utah Counties)
  • Orthotics and Prosthetics
  • Physical Therapy (in Davis, Salt Lake, Utah & Weber Counties)
  • Residential Treatment Center
  • Skilled Nursing Facilities (in Davis, Salt Lake & Utah Counties)
  • Specialty Pharmacy

Step One - Contracting

Our Contracting Committee reviews applications within 15-20 business days.  If the application is not approved, you will be notified. If the application is approved, one of our Contract Executives will extend a contract to you. When we receive the signed contract back from you, we will initiate the credentialing of all of the providers that are listed in Exhibit B. Here is the link to the application: Provider Application Form. If you need to make an update to your practice please use the Provider Information Update Form.
  • Please include a copy of the business W-9 Tax Form with the application.

Step Two - Credentialing

Providers cannot see members until Credentialing is complete. The Credentialing Committee is chaired by our Medical Director and they give the final determination if a provider meets our credentialing criteria. This committee meets the first Monday of each month, excluding holidays. Credentialing typically takes 6-8 weeks to complete.

Adding a new Provider

If you already have a contract and are adding a new provider, please click on the Provider Credentialing tab (on the left side of page).

Provider Business Update

If you are a provider and need to update your existing business information please use the following Provider Update Form.

For General Inquires or to Contact a Representative:
telephone: 801-587-2838 Option 4


Todd Randall, Provider Contracting Executive

Todd.randall@hsc.utah.edu

801-587-2774

  • Negotiates contracts with all providers in the state of Utah and surrounding areas

Brenda Groves, Provider Contracting Executive

Brenda.groves@hsc.utah.edu 

801-587-2881

  • Negotiates contracts with all providers in the state of Utah and surrounding areas

Stephanie Haws, Provider Contracting Executive

Stephanie.haws@hsc.utah.edu 

801-213-0140

  • Negotiates contracts with all providers in the state of Utah and surrounding areas

Provider Relations:  provider.relations@hsc.utah.edu 
Phone: 801-587-2838 option 2

  • Escalated provider issues
  • Provider contracting questions
  • Claims concerns not addressed by Customer Service

Individual Provider Credentialing:  provider.credentialing@hsc.utah.edu

Organizational Facility Credentialing: provider.credentialing@hsc.utah.edu

Phone: 801-587-2838 option 3


Provider Contracting: providercontracting@hsc.utah.edu

Phone: 801-587-2838 Option 4



Emily Bird, Provider Consultant

emily.bird@hsc.utah.edu

801-587-2666

Provider Consultant Map

Salt Lake County in Utah and all Nevada:

  • Physicians, practitioners, physical therapy providers, chiropractors, behavioral health providers, audiologists, podiatrists, optometrists, dentists; independent hospitals, and ambulatory surgical centers

Throughout Utah:

  • Pathology labs
  • Dialysis centers
  • Steward hospitals
  • Physician Group of Utah (PGU)

 


Sandra Campbell, Provider Consultant

Sandra.campbell@hsc.utah.edu

801-587-2943

Provider Consultant Map

Beaver, Carbon, Emery, Garfield, Grand, Iron, Juab, Kane, Millard, Piute, San Juan, Sanpete, Sevier, Utah, Washington, and Wayne counties in Utah; and all Colorado and Wyoming:

  • Physicians, practitioners, physical therapy providers, chiropractors, behavioral health providers, audiologists, podiatrists, optometrists, dentists; independent hospitals, and ambulatory surgical centers

Throughout Utah:

  • HCA physicians
  • Anesthesia Groups
  • HCA MountainStar Hospital System
  • Durable Medical Equipment companies

 


Mary Carbaugh, Provider Consultant

Mary.carbaugh@hsc.utah.edu 

801-587-2920

Provider Consultant Map

Box Elder, Cache, Daggett, Davis, Duchesne, Rich, Morgan, Summit, Tooele, Uintah, Wasatch, and Weber counties in Utah; and all Idaho:

  • Physicians, practitioners, physical therapy providers, chiropractors, behavioral health providers, audiologists, podiatrists, optometrists, dentists; independent hospitals, and ambulatory surgical centers

Throughout Utah:

  • Interpreting Agencies
  • Intermountain Healthcare
  • Skilled Nursing Facilities
  • Home Health, and Hospice
  • Long-Term Acute Care hospitals

About Provider and Facility Search

Definitions & Terminology Used in Search

University of Utah Contracting Criteria

Provider information in this directory is collected from information that we receive from our provider network and updated 5 days per week, excluding weekends, holidays, or interruptions due to upgrades, system maintenance, or unplanned outages. This information is subject to change at any time.