To enroll with UHIN, please select the tab for your organization type. Please complete the requested forms for your organization type and follow the instructions for returning them to UHIN.
Please note: the billing software provided by UHIN is compatible with PCs. If you are using a Mac or other type of non-PC system, you must have a Windows overlay (the most common one for Macs is “Parallels”) in order to run this software.
If you’re ready to get started with our services, please complete our Electronic Commerce Agreement (ECA) and the ECA Amendment (download and fill out before submitting). Please review the ECA carefully and have it signed by the person who is authorized to sign contracts for your office.
Along with the ECA, please submit the following forms:
Please note: UHIN can complete the enrollment process for sending claims to certain payers on your behalf. However, UHIN cannot handle payer contracting.
UHIN can connect you to send claims to Utah Medicaid and to Medicare for Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington State and Wyoming. As a first step, both Medicaid and Medicare require you to complete a request to bill them electronically. UHIN CANNOT complete either the Medicaid or Medicare electronic billing request for you.
You can return the UHIN ECA and EDI Enrollment Form in one of several ways:
If you’re ready to connect with UHIN, please request a copy of our payer contract. In your request, please include your company’s name, the contact person’s name, email address, and phone number. We will respond to your request within 48 hours.
If you’re ready to connect with UHIN, please request a copy of our clearinghouse contract. In your request, please include your company’s name, the contact person’s name, email address, and phone number. We will respond to your request within 48 hours.