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Provider Relations

doctor high-fiving young patient

Provider Relations

Provider Relations

  • Provider Relations

    providers@healthchoiceutah.com
    Fax: 801-646-7207

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

     

  • Amy Prince, Provider Network Service Representative

    amy.prince@healthchoiceutah.com

    801-587-5446

    Network Services Representative Map

    Primary contact for contracting, demographic updates, credentialing, and claim concerns for providers and hospitals in: Carbon, Emery, Grand, Salt Lake, and San Juan Counties.

    Primary contact throughout Utah for:

    • Intermountain Healthcare
    • Home Health Agencies
    • Hospice Services
    • Personal Care Agencies
  • Kayanne Malin, Provider Network Service Representative

    kayanne.malin@healthchoiceutah.com

    801-646-7277

    Network Services Representative Map

    Primary contact for contracting, demographic updates, credentialing, and claim concerns for providers and hospitals in: Beaver, Garfield, Iron, Juab, Kane, Millard, Piute, Sanpete, Sevier, Utah, Washington, and Wayne Counties.

    Primary contact throughout Utah for:

    • HCA MountainStar Hospitals and Physicians
    • Holy Cross Hospitals and Physicians
    • Durable Medical Equipment Companies
    • Laboratory Services
  • Lisa DeKarver, Provider Network Service Representative

    lisa.dekarver@healthchoiceutah.com

    801-646-7274

    Network Services Representative Map

    Primary contact for contracting, demographic updates, credentialing, and claim concerns for providers and hospitals in: Box Elder, Daggett, Davis, Duchesne, Rich, Morgan, Summit, Tooele, Uintah, Wasatch, and Weber Counties.

    Primary contact throughout Utah for:

    • University of Utah Hospitals and Clinics
    • Skilled Nursing Facilities
    • Long-Term Acute Care Hospitals
    • Dialysis Centers

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 Health Choice Utah permission to publish a link to your site in our provider directories. Health Choice Utah 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.