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Utah · UT

Medical Billing Services in Utah

Remote medical billing and revenue cycle management for Utah practices that bill Utah Medicaid, Medicare, Medicare Advantage and commercial plans such as Regence BlueCross BlueShield of Utah. Cleaner claims, fewer denials and faster payments, with no upfront cost.

MedicareJF · Noridian Healthcare SolutionsPart A/B contractor
MedicaidUtah MedicaidPaid mostly through managed care plans
Coverage6+ major citiesSalt Lake City, West Valley City, Provo and more
Medicare filing12 monthsFrom date of service
Utah payers we bill every day
Noridian Healthcare Solutions (Medicare)Utah MedicaidRegence BlueCross BlueShield of UtahSelectHealthUniversity of Utah Health PlansMolina HealthcareUnitedHealthcareMedicare AdvantageTRICAREWorkers' comp
Billing support for Utah

A billing team that knows Utah payers

SelectHealth, owned by Intermountain Health, and Regence lead Utah's commercial market. Most Utah Medicaid members in urban counties are enrolled in Accountable Care Organizations, and Utah's young, fast-growing population means pediatric and obstetric billing are a big share of claims.

Provider Concerns handles that work for you, remotely. Our team verifies coverage and plan type before each visit, codes and scrubs every claim, submits it electronically, posts payments and works every denial by reason code. You get a single point of contact and monthly reports on collections, denials and days in A/R, so you always know where your revenue stands.

We work with solo physicians, specialty groups, clinics and multi-location practices across Utah, including Salt Lake City, West Valley City, Provo, West Jordan, Orem and St. George. Because we work inside your existing EHR or practice management system, there is nothing to install and no disruption to your front desk. Learn more about our medical billing, denial management, claims processing and revenue cycle management services.

What we handle for Utah practices

  • Medicare Part B claims through Noridian Healthcare Solutions (Jurisdiction F)
  • Utah Medicaid claims, mostly through managed care plans
  • Medicare Advantage plans, with plan-level authorization tracking
  • Commercial payers such as Regence BlueCross BlueShield of Utah, SelectHealth and University of Utah Health Plans
  • DME claims to Noridian (DME Jurisdiction D)
  • Eligibility checks, coding review, A/R follow-up and patient statements
  • Monthly reporting on collections, denials and days in A/R
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At a glance

Utah billing rules at a glance

The payer rules that shape how Utah claims get paid. Plan contracts can differ, so we confirm each payer's current requirements during onboarding.

Medicaid program

Utah Medicaid, paid mostly through managed care plans

Medicaid filing limit

Set by the state program and by each managed care plan contract; we confirm every payer's current window during onboarding

Medicare contractor (Part A/B)

Noridian Healthcare Solutions, Jurisdiction F

Medicare filing limit

12 months (one calendar year) from the date of service

DME contractor

Noridian (DME Jurisdiction D)

Major commercial payers

Regence BlueCross BlueShield of Utah, SelectHealth, University of Utah Health Plans, Molina Healthcare and UnitedHealthcare

Our services

Revenue cycle services for Utah practices

Pick one service or hand us the whole revenue cycle. Either way, you keep full visibility into every claim.

Medical billing

Charge entry, claim scrubbing and electronic submission to every Utah payer you work with.

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Claims processing

Clean claims built to each payer's edits, so fewer are rejected before they are ever reviewed.

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Denial management

Every denial worked by reason code, corrected, appealed and tracked until it is paid.

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Revenue cycle management

Eligibility, coding review, payment posting, A/R follow-up and monthly reporting in one service.

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Denial prevention

Common Utah denials and how we prevent them

Most denials are preventable. These are the ones we see most often for Utah practices, and the checks we run to stop them before a claim goes out.

01

Wrong Medicaid plan

Utah Medicaid members can switch managed care plans, and claims sent to the old plan are denied. We re-check plan assignment before each visit and on every rejected claim.

02

Medicare Advantage vs. Original Medicare

Patients move between Original Medicare and Medicare Advantage plans during open enrollment. We verify the plan at every visit so claims don't go to Noridian Healthcare Solutions when a private plan should be billed.

03

Missing prior authorization

Many Utah plans require approval for imaging, procedures and specialty visits. We request and track authorizations before the date of service.

04

Coding and modifier errors

Bundling edits, missing modifiers and diagnosis codes that don't support medical necessity are among the most common avoidable denials. Certified coders review claims before they go out.

05

Timely filing

Medicare, Utah Medicaid and commercial plans each set different deadlines. We track every open claim against its payer's window so nothing ages out.

06

Coordination of benefits

Secondary coverage, workers' comp and auto claims need the right payer order. We confirm it up front and bill secondary payers as soon as the primary pays.

How it works

Getting started is simple

No long setup and no upfront cost. Here is how Utah practices move their billing to Provider Concerns.

Free billing review

We look at your collections, denials and A/R to find where revenue is being lost.

Payer setup

We confirm your Utah Medicaid, Medicare and commercial enrollments and each payer's rules.

Clean claims

We verify eligibility, code, scrub and submit claims inside your current system.

Follow-up & reports

Denials and aging balances are worked every week, with monthly reporting.

Cities we serve

Medical billing across Utah

We support practices statewide, from large metro groups to rural clinics. Billing is handled online, so location is never a barrier.

Salt Lake CityWest Valley CityProvoWest JordanOremSt. George
Specialties

Specialties we bill for in Utah

FAQ

Frequently asked questions about medical billing in Utah

Do you bill Utah Medicaid?
Yes. Most Utah Medicaid members are enrolled in managed care plans, and each plan has its own enrollment, authorization rules, filing window and portal. We confirm the patient's assigned plan before every visit, bill that plan directly and track its deadlines separately from fee-for-service claims.
Who is the Medicare contractor for Utah?
Medicare Part A and Part B claims in Utah are processed by Noridian Healthcare Solutions, Jurisdiction F. Durable medical equipment claims go to Noridian (DME Jurisdiction D). We bill both and track Medicare's 12-month filing limit on every claim.
Which commercial insurance plans do you work with in Utah?
We bill all major commercial payers in Utah, including Regence BlueCross BlueShield of Utah, SelectHealth, University of Utah Health Plans, Molina Healthcare and UnitedHealthcare, along with Medicare Advantage, TRICARE and workers' compensation plans. If you work with a smaller local plan, we set up its rules during onboarding.
Can you support practices in Salt Lake City and other Utah cities?
Yes. Billing is handled remotely in your existing practice management system or EHR, so we support practices anywhere in Utah, including Salt Lake City, West Valley City, Provo, West Jordan, Orem and St. George, as well as smaller towns and rural clinics.
What is the Medicaid timely filing limit in Utah?
Set by the state program and by each managed care plan contract; we confirm every payer's current window during onboarding. Late corrected claims and appeals have their own deadlines, which we track as well.
How much does medical billing cost for a Utah practice?
Pricing depends on your specialty, claim volume and the services you need. There is no upfront cost. We start with a free billing review of your collections, denials and A/R, then give you a clear quote.
Nearby

Other states we serve in the West

Ready to get paid faster in Utah?

Get a free billing review. We'll look at your collections, denials and A/R and show you exactly where revenue is being lost.

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