Log in or register to:
• View claims, payments, and remittance advices.
• Verify patient’s’ eligibility, benefit overview, and real-time deductible and out-of-pocket maximum amounts.
• Request and review prior authorizations.
BILLING RESPECTIVE CODE SETS
In accordance with the International Classification of Diseases, 10th Revision (ICD-10) and Current Procedural Terminology (CPT) Guidelines for Coding and Reporting, Mountain Health Co-Op will begin to deny claims on April 1st, 2022, when CPT and ICD do not cross match in the respective code set being billed. For accurate reporting of ICD-10/CPT, the documentation should describe the patient’s condition, services as well as symptoms, problems, and reasons for the encounter. Coding to the highest level of specificity is required when supported by the medical record and to support medical necessity.
Use this form, along with missing documentation, for MDOC claim denials.
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.
Submitting Additional Documentation
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 [email protected]
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.
Join Our Network
We’re pleased to announce the successful launch of the new, secure Mountain Heal CO-OP Provider Portal.
The Federal No Surprises Act went into effect January 1, 2022, bringing new requirements for health plans and providers.
Mountain Health CO-OP, in collaboration with University of Utah Health Plans (UUHP), has been in the process of creating a new secure portal to replace the current LINK Provider Portal.
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.