Please allow 24 hours to receive your registration confirmation.
*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.
Being a co-op provider
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.
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.
Medical Prior Auth Forms:
Drugs Prior Auth Forms:
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
You may also email your request for criteria to UUHP_UM@hsc.utah.edu
This manual is where you can look for policies and procedures.
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.
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.