Welcome to:

Provider Relations & Contracting

On This Page

Provider Contracting

Provider Application Process

Step One

To apply, complete the Provider Application form and email it to providercontracting@hsc.utah.edu, or fax the completed form to 801-281-6121.

Note: Incomplete Applications—Including degree (e.g. MD, APRN), hospital privileges/admitting plan, Group and Individual NPI (where indicated), Organization’s Medicare and Medicaid enrollment numbers, and W-9 Taxpayer Identification Form—will be denied.

Our Contracting Committee reviews applications within 15 to 20 business days.

  • If the application is approved, one of our Contracting Executives will extend a contract to you. When we receive the signed contract back from you, we will initiate the credentialing of all providers listed in Exhibit B.
  • If the application is denied, you will be notified.

 

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

Step Two

Credentialing typically takes 6-8 weeks to complete. The Credentialing Committee makes the final determination as to whether a provider meets our credentialing criteria. This committee meets the first Monday of each month, excluding holidays. Once credentialed, providers can begin to see members.

Adding a new Provider

If you already have a contract and are adding a new provider, please click on the Provider Credentialing tab (in the provider navigation bar, above), and follow the steps under “Where to Start? Let’s Get Started.”

Provider Business Updates

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

Provider Relations

  • Provider Relations

    provider.relations@hsc.utah.edu
    801-587-2838 option 2

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

    Provider Credentialing
    provider.credentialing@hsc.utah.edu
    801-587-2838 option 3

  • 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
    • Holy Cross Hospitals
    • Holy Cross Medical Group

  • 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

Provider Information Update Form

Please include any associated provider(s) and NPI(s) number(s) that we need to have listed under the change. If needed, attach a provider roster, W-9, or other necessary documentation below. This information is required to complete this request.

Anything with a * next to it is a required field.

CONTACT INFORMATION

EXISTING ADDRESS
EXISTING BILLING ADDRESS

PRACTICE INFORMATION

* ASSOCIATED PROVIDER: (IF MULTIPLE PROVIDERS, ATTACH INFORMATION AS A SPREADSHEET OR OTHER FORM OF ROSTER BEFORE SUBMITTING THIS FORM.)
NEW PRACTICE ADDRESS
(PICK ALL THAT APPLY)
Website URL: By providing the URL to your clinic website, you give University of Utah Health Plans permission to publish a link to your site in our provider directories. U of U Health Plans assumes no responsibility or liability for the information displayed on your site.
NEW BILLING ADDRESS

Unlimited number of files can be uploaded to this field.
256 MB limit.
Allowed types: pdf, doc, docx, ppt, pptx, xls, xlsx, xml, zip.