About Provider and Facility Search
Information about providers and facilities change frequently and often without notice. Changes are not always reported in a consistent manner and timely and therefore may not be reflected in the Provider and Facility Search database. UUHP verifies and updates provider, hospital, facility, and medical equipment/supply vendor information at initiation of contract, initial credentialing, upon recredentialing every three years, or as reported by the provider or facility.
Facility Search Options and Search Results
All search criteria are optional.
You can search by a facility's name or by facility type (hospital, urgent care clinic, home health, etc.) You can search by city, zip or county. In the UUHP version of Facility Search, it is recommended to search by the plan you're on to limit search results to that plan. Search Results display a facility's name, address, phone number, and a link to maps and directions.
Provider Search Options and Search Results
All search criteria are optional.
You can search by a provider’s name, gender, specialty, languages spoken, or by Group/Location/Facility name. You can search by city, zip or county. In the UUHP version of Provider Search, it is recommended to search by the plan you're on to limit search results to that plan. Search Results display the provider name, gender, primary and secondary specialties, languages, address, phone number, hospital affiliations, board certification, whether or not a provider is accepting new patients, and a link to maps and directions.
University of Utah Health Plans Contracting Criteria
The University of Utah Health Plans (UUHP) contracts with physicians and other health care professionals and facilities for all of our product lines including commercial, marketplace and Medicaid to offer provider networks essential to the delivery of health care and services to our members. UUHP is committed to the “triple aim” of improving experience and quality of care, improving the health of populations, and reducing the per capita cost of care. We recognize the importance of population health and payment reform and have developed extensive care management and value-based payment programs that improve health and align provider reimbursement with value and positive outcomes.
Provider applications to participate in any UUHP network are considered based on the following:
- Provider applications to participate in any UUHP network are considered based on the following:
- Network adequacy requirements based on state and/or federal guidelines
- Network adequacy requirements based on the current or expected population of a given geographic area (usually defined by county or zip code)
- Network adequacy requirements based on provider type and/or specialty
- Network composition based on scope of services required by payer such as employer, health plan, union/trust, government entity, etc.
- Demographic needs including but not limited to languages spoken
- Existing, non-compensated, referral patterns with current network providers and/or UUHP members
- Quality, patient experience and cost data as available which may include and is not limited to:
- Comparisons of provider practice data to benchmark market averages related to compliance with industry-standard quality measures. Examples include: Hemoglobin A1c(HbA1c) testing in diabetic patients, breast cancer screening prevention rates, and child immunization rates;
- Industry published and available patient surveys and reviews;
- Comparisons of provider practice cost data to benchmark market averages on a per-member-per-month basis for similar populations;
- The credentialing process which may include and is not limited to, verifying appropriate licensure, education and training, board certification, DEA licensure, accreditation/certification status, review of sanctions and a review of an acceptable history of professional liability claim.
All providers must be approved through our credentialing process before they may participate in any network.
UUHP plans are designed based on specific criteria that we apply to select participating primary care physicians and specialists which include:
- General Surgery
- Obstetrics and gynecology
Additional primary care physicians, specialists and facilities are included if they meet our credentialing requirements to ensure members have access within are reasonable distance to the number and types of providers needed.
Board Certification Information
To verify the status of Board certification for a physician, visit ABMS at https://www.abms.org/.
- Select 'VERIFY CERTIFICATION'
- Click on 'IS MY DOCTOR BOARD CERTIFIED'
- Enter search criteria and select 'SEARCH'
For Doctors of Osteopathic Medicine, visit AOA at https://www.osteopathic.org. The search can be performed by selecting 'DOCTORS THAT DO' and entering search criteria. The search can be reached directly at this link also.
Some hospitals are accredited by the Joint Commission or DNV. UUHP verifies hospital accreditation at least every three years by referencing the Joint Commission website or the DNV website. Consumers can verify a hospital's accreditation status by visiting the Joint Commission Quality Check website or the DNV website
Hospital Quality Data
Hospital quality ratings and the date those ratings were last updated can be accessed by visiting the Medicare Hospital Compare website.
Providers must meet UUHP initial credentialing standards and recredentialing standards every three years including, but not limited to, verification of appropriate licensure, education and training, work history, DEA licensure, review of sanctions and review of an acceptable history of professional liability claims. Providers not meeting UUHP credentialing standards are subject to rejection or termination from network participation.
Provider and Facility information changes frequently and often without notice. Some changes may not be reflected in a Provider or Facility Search. Inclusion of a provider or facility in the Provider or Facility Search is not a guarantee of coverage for any health insurance plan. Before receiving medical services, it is recommended that you consult UUHP to verify a provider’s or facility's participation, authorization and referral requirements, and benefits including exclusions and limitations. Additionally, it is recommended that you confirm whether a provider or facility accepts your insurance plan before you receive services.