Medical Billing Built for Utah Healthcare Providers
Utah took an unusually gradual path to Medicaid expansion: SB 96 first expanded coverage to adults up to 100% of the federal poverty level effective April 1, 2019, and it wasn't until CMS approved a full expansion waiver on December 23, 2019 that Utah moved to the standard 138% FPL threshold with the enhanced 90% federal match, effective January 2020. Utah Medicaid itself runs on a distinctive payer-led ACO model — coverage is delivered through four Accountable Care Organizations: SelectHealth Community Care, Molina Healthcare of Utah, Healthy U, and Health Choice Utah — rather than the standard commercial-MCO contracts most states use. SelectHealth, the insurance arm of Intermountain Health, is also the dominant commercial and Medicare Advantage payer in the state, so its claim and authorization rules carry outsized weight in Utah. Regence BlueCross BlueShield of Utah is the state's Blue Cross licensee.
Whether you're in Salt Lake City, West Valley City, Provo or anywhere else in Utah — ZenoMedix RCM provides the same certified billing expertise with deep knowledge of local payer rules and Utah Medicaid requirements.
Major Payers We Work With in Utah
Utah Medicaid
Utah Medicaid — delivered through a payer-led ACO model with four contracted ACOs: SelectHealth Community Care, Molina Healthcare of Utah, Healthy U, and Health Choice Utah. Utah expanded in two phases: SB 96's partial expansion to 100% FPL in April 2019, then full ACA expansion to 138% FPL in January 2020 after CMS approval.
HIPAA Compliance
Full HIPAA compliance for all UT providers. We stay current with all Utah billing regulations. View HIPAA Statement →
Every City in Utah — We're Your Billing Team
Remote billing means you get the same expert service whether you're in a major metro or a smaller community across Utah.
75+ Specialties Served Across Utah
Each specialty has a dedicated billing team trained on its CPT codes, modifiers, and payer-specific requirements in Utah.
Everything Your Practice Needs — Nothing You Don't
Utah Billing FAQ
Yes. Utah Medicaid runs on a payer-led ACO model with four contracted ACOs — SelectHealth Community Care, Molina Healthcare of Utah, Healthy U, and Health Choice Utah — so we confirm which ACO a patient is assigned to before submitting rather than billing Utah Medicaid as a single fee-for-service payer.
Very. SelectHealth, Intermountain Health's insurance arm, is the dominant commercial and Medicare Advantage payer in Utah, and it also runs one of the four Medicaid ACOs. Our Utah coding team bills SelectHealth alongside Regence BlueCross BlueShield of Utah, UnitedHealthcare, Aetna, and Cigna, tracking each one's documentation and modifier requirements.
It can for eligibility verification. Utah first expanded to 100% FPL under SB 96 in April 2019, then moved to full 138% FPL expansion in January 2020 after CMS approval, so patients enrolled during that transition sometimes carry eligibility histories worth double-checking rather than assuming.
Most Utah practices are fully onboarded and submitting live claims within 48 hours of signing. We're month-to-month — no long-term contract — and we work your existing claims backlog into the transition so nothing falls through.
We serve Utah practices statewide, from Salt Lake City, West Valley City, Provo, West Jordan, and everywhere in between — not just the biggest metro area.