Provider applications to participate in any U of U Health Plan network are considered based on the following:

• Business needs
• The credentialing process

All providers must be approved through our credentialing process before they may participate in any network.

Business needs may include, but are not limited to:

• 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 the scope of services required by the payer, such as employer, health plan, union/trust, government entity, etc.
• Network performance requirements in terms of cost/utilization, quality measures, outcomes, access, and/or patient or physician satisfaction
• Demographic needs, including but not limited to languages spoken
• Existing, non-compensated, referral patterns with current network providers and/or U of U Health Plans members

Benefits of participating with a U of U Health Plan network include:

• Claim payments are made to you directly on a weekly basis
• Provider Relations representatives are available to help you and your staff
• Inclusion in our online and printed provider directories made available to brokers, employers, and members for the applicable products
• Member benefits are designed to encourage the use of network providers
• Eligibility to register for Provider Portal, our online tool to verify eligibility, check claims status, submit inquiries, and more

IMPORTANT NOTICE: We are not currently accepting applications for the following provider types:

• Durable Medical Equipment / Medical Supplies
• Laboratory
• Infusion Suites
• General Dentistry (Oral Surgeons may apply)
• Mid-level, non-prescribing Behavioral Health Providers in Salt Lake, Utah, Davis, Weber, and Washington counties.

STEP 1: SUBMIT AN APPLICATION

To be considered for network participation, please complete the Provider Application Form below.

STEP 2: APPLICATION REVIEW

Our Contracting Committee reviews all applications within 25–30 business days.

• If your application is approved, a Contracting Executive will send you an agreement to review and sign.
• If your application is not approved, you will be notified in writing. 

STEP 3: CREDENTIALING 

Once we receive your signed agreement: 

• We begin credentialing all providers listed in Exhibit B.
• Credentialing typically takes 6–8 weeks to complete.
• The Credentialing Committee meets on the first Monday of each month (excluding holidays) and will make final determinations on credentialing approval.
• You will be notified if additional credentialing is not required. 

STEP 4: PROVIDER ACTIVATION 

When credentialing is complete, providers may begin seeing members on their approved effective date. 

Update Your Practice Information:

If you need to make an update to your practice, use the Provider Information Update Form, not a new Application.

Adding a New Provider:  

If you already have a contract and are adding a new provider, follow the instructions under Practitioner Credentialing.

Provider Business Updates: 

If you need to update your existing location or business information, complete and submit the Provider Information Update Form.