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Get the free University of Utah Health Plans Trading Partner Setup Form

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This form is intended for setting up trading partners for submitting claims to the University of Utah Health Plans. It collects necessary information such as trading partner number, types of files
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How to fill out University of Utah Health Plans Trading Partner Setup Form

01
Obtain the University of Utah Health Plans Trading Partner Setup Form from the official website or contact the support team.
02
Fill out the basic information section, including the name of the organization, address, and contact details.
03
Provide the Tax ID number and necessary identifiers required for trading partner setup.
04
Complete the specific section for electronic data interchange (EDI) capabilities, indicating the types of transactions you will send or receive.
05
Review and confirm that all information is accurate and complete.
06
Sign and date the form where indicated.
07
Submit the completed form through the designated submission method outlined in the instructions (email, fax, or online portal).

Who needs University of Utah Health Plans Trading Partner Setup Form?

01
Healthcare providers who want to partner with University of Utah Health Plans for billing and claims processing.
02
Organizations seeking to establish electronic transactions for healthcare services.
03
Entities that require access to University of Utah Health Plans' systems for data exchange.
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The University of Utah Health Plans Trading Partner Setup Form is a document used to establish a formal business relationship between trading partners and the University of Utah Health Plans for the purpose of electronic data exchange.
Entities such as healthcare providers, facilities, billing companies, and others involved in electronic transactions with University of Utah Health Plans are required to file the form.
To fill out the form, provide accurate contact information, specify the type of organization, choose the applicable electronic transactions, and ensure all required sections are completed before submission.
The purpose of the form is to facilitate secure and efficient electronic communication between the University of Utah Health Plans and its trading partners by establishing the necessary protocols and data exchanges.
Information that must be reported includes organization name, contact details, National Provider Identifier (NPI), tax identification number, type of transactions being conducted, and any specific communication protocols.
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