Need a Prior Authorization?
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Welcome, Utah Healthcare Providers
Contracted providers are an essential part of delivering quality care to our members. We value our partnership and appreciate the family-like relationship that you pass on to our members.
As our partner, assisting you is one of our highest priorities. We welcome your feedback and look forward to supporting all your efforts to provide quality care.
Molina Healthcare of Utah participates in the Utah Medicare, Medicaid, CHIP and Marketplace programs.
If you have any questions, call Provider Services at 1-855-322-4081.
What's New / Recent Updates
Provider Manual Update - July 2022
We have recently updated the provider manual to include the following:
- New Clinical Policy website information added to the Healthcare Services chapter
- COB language updated in the Claims and Compensation chapter
- Interoperability section added to the Risk Adjustment Management Program chapter
- Updated the Continuation of Benefits During an Appeal section in the Complaints, Grievance and Appeals Process chapter
The updated manual can be found by visiting our Provider Manual page or by clicking here.
Your Opinion Matters to Molina
Contract Request Form
Do you need to add, terminate, or make demographic changes to an existing Provider in your group?
Please notify Molina Healthcare at least 30 days in advance when you:
- Change office location, hours, phone, fax, or email.
- Add or close a location.
- Add or terminate a provider.
- Change in Tax ID and/or NPI.
- Open or close your practice to new
patients (PCPs only).
Frequently Used Forms
- Prior Authorization Form (Medical, Behavioral Health, and HCPCS/JCode PA Request Forms)
- Synagis Prior Authorization Form
- Pharmacy/Medication Exception Prior Authorization Form
- Provider Appeal Request Form