*Log in to view Claims, Eligibility, & Prior Authorizations.
– View claims, payments, and remittance advices.
– Verify patients’ eligibility, benefit overview, and real-time deductible and out-of-pocket maximum amounts.
– Request and review prior authorizations.

Provider Contacts

Idaho

Greg Sonnenberg – Vice President

Lindsey Sheldon – Provider Network Specialist

855-447-2900 – Option 6

provider@mhc.coop

Montana

Leah Martin – Director

Jill Martin – Provider Network Specialist

855-447-2900 – Option 6

provider@mhc.coop

Wyoming

Morris McGaugh – Director

855-447-2900 – Option 6

provider@mhc.coop

For patient eligibility and benefits:
1-844-262-1560

For prior authorizations for medical services:
1-801-587-2851

For prior authorizations for prescription drugs:
855‐885‐7695
 
Fax inpatient notifications:
1-801-262-0103
 
Fax outpatient prior authorization requests:
Provider Forms

Use this form to add a new provider to your already contracted group, or to notify the CO-OP about a name or address change.

Use this form to remove a provider that has left the group.

Please complete page 2 of this form to add a new location or change a location address.

Claims

Claims Submission

Claims should be submitted through our plan administrator’s clearinghouse, the Utah Health Information Network (UHIN).

Visit the website for more information.

How to Submit Claims

Receiving Funds

We must have a W-9 on file before we can make any payments to you. You can fax your W-9 form to 801-281-6121. If we do not have a direct deposit set up for your group, we will send a paper check.

How to set up EFT

Appeals

For questions about appeals:
1-844-262-1560

 
Preauthorizations
Policies

Utilization Mgmt. Medical Policies

We would be happy to provide you with a copy of the criteria we use to make utilization management decisions.

Contact the UM team for more info:
801-587-6480 or 888-271-5870
Option 2

You may also email your request for criteria to UUHP_UM@hsc.utah.edu

Provider Manual

This manual is where you can look for policies and procedures.

PDF Manual

Provider Policies

Mountain Health CO-OP has contracted with the University of Utah Health Plans to both process claims and oversees our care and utilization management programs.

Through these programs, care and utilization management teams assist members in obtaining the right care at the right time. Through their work, these teams help our members achieve the best outcome, using nationally-recognized, evidence-based guidelines.

Access Medical Policies

Behavioral Health Policies

Being a co-op provider.

As a non-profit, member-owned health insurance co-op, we are dedicated to ensuring access to quality cost-effective health insurance for our communities.

We offer an array of benefit plans that will fit your patient’s individual needs.

We believe doctors and hospitals should be fairly compensated for the work they perform.

Questions?
provider@mhc.coop

 

Join Our Network

Newsletters
Summer 2021

The CO-OP is excited to share our new website. This website has been built to create an
easier user experience for our members, providers, and brokers. The website is easier to
navigate, with updated information, a user-friendly…

Spring 2021

What a challenging year we have endured. We applaud you for your dedication and innovation in meeting this challenge to continue providing care to our communities in the safest possible way…

Winter 2020

It has been a challenging year, and we hope you, your staff, and your loved ones are staying healthy. Unfortunately, the pandemic still has a strong foothold in our communities. We are eagerly monitoring news of treatments and vaccines…