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Regence BlueCross BlueShield of Utah Logo
Utah State For Physicians, Other Health Care Professionals and Facilities
  Contact Us

What would you like assistance with today?

Patient coverage, benefits and eligibility

Access member information online

  • View member cards
  • Verify patient coverage, benefit types and eligibility effective dates
  • View estimates of patients' out-of-pocket expenses for select procedures and services
  • View patient benefit information, including office visit copayments and an overview of major medical coverage
  • Obtain real-time accumulation amounts for deductibles, out-of-pocket and coinsurance maximums for our members

Register or login »

Access member information over the phone

  • Access eligibility and claims-related information 24 hours a day, seven days a week by calling Customer Service and using the Interactive Voice Response (IVR) system.
  • For all other questions that cannot be resolved through Provider Center or IVR, contact a Provider Customer Service specialist.

Claims and payments

Access information online

  • View fee schedules
  • View claims status and payment information
  • Review the status of your organization's submitted claims and view payment information
  • Search for and print payment vouchers by provider name, voucher number or check number

Register or login>>

Access member information over the phone

  • Access eligibility and claims-related information 24 hours a day, seven days a week by calling Customer Service and using the Interactive Voice Response (IVR) system.
  • For all other questions that cannot be resolved through Provider Center or IVR, contact a Provider Customer Service specialist.

Update your information

Help us keep critical information about your practice up-to-date by completing a Provider Information Update Form when:

  • A provider leaves or joins your clinic or practice
  • You have a change to your:
    • Organization's address
    • Phone number
    • Tax identification number
    • National Provider Identifier number

Note: Please do not use this form to update/maintain Provider Center Organization Access Identification (OAID) numbers. If the current Primary Account Manager (PAM) cannot perform the update, contact Provider Center Technical Support at 1 (888) 427-0470.

Addresses

Paper claims are only accepted when they are submitted by:

  • Members.
  • Providers who practice outside our service area and are not subject to state or other local paperless claim mandates.

Mail to:

Claims address:

  • Regence BlueCross BlueShield of Utah
    P.O. Box 30272
    Salt Lake City, UT 84130-0272

Federal Employee Program (FEP):

Claims submission address:

  • Regence BlueCross BlueShield of Utah
    Federal Employee Program
    P.O. Box 30272
    Salt Lake City, UT 84130-0272

Federal Employee Claims that require Medical Records

  • Regence BlueShield
    P.O. Box 2668
    Seattle, WA 98111-2668

Mail all other correspondence to the applicable address:

All correspondence (except Regence MedAdvantage) to:

  • Regence BlueCross BlueShield of Utah
    P.O. Box 1271, MS C7A
    Portland, OR 97207-1271

Regence MedAdvantage:

Regence BlueCross BlueShield of Utah
P.O. Box 12625
Salem, OR 97309-0625

AIM order numbers for diagnostic imaging procedures

BlueCard® (out-of-area) members or claims

BlueCard Customer Service

  • 1 (801) 333-2370 or 1 (800) 782-8211
  • 8:00 a.m. to 4:30 p.m.

Automated Eligibility:

  • 1 (800) 676-2583

View BlueCard Program information and resources >

Contracting or credentialing

We contract with physicians, dentists, other health care professionals and facilities to form provider networks essential for the delivery of health-care and dental services to our members.

All providers must be credentialed before they can participate in our provider networks. Once credentials have been verified, a provider agreement is offered. 

Credentialing and contracting steps:

  1. View a list of providers we contract with to make sure we contract with your specialty >
  2. Learn more about our provider networks >
  3. Register for our web portals >
  4. Learn about our credentialing policy and complete a credentialing application >
  5. Once credentials are verified, you will receive an email from our Credentialing department.
  6. Sign up for for eContracting >
To check the status of a submitted credentialing application, contact our credentialing department.

Coordination of Benefits / Maintenance of Benefits

  • 1 (801) 333-2100
  • 1 (800) 624-6519

Electronic transactions

Availity

1 (800) 282-4548

 

Medical providers, select option 1, then listen for the option you need assistance with

 
Dental providers, select option 4
support@availity.com
   

Medical Electronic Attachment, Inc. (MEA) FastAttachTM - medical

National Electronic Attachment, Inc.
(NEA
) FastAttachTM - dental

Office Ally

Utah Health Information
Network (UHIN)

Regence EDI Support Center

Learn more about electronic transactions >

Fee schedules

Fee schedules and other pricing documents are available in the Reference Library on our Provider Center.

Fraud or abuse

  • General: 1 (866) 626-8555
  • Medicare Advantage (Part C): 1 (800) 548-4850
  • Medicare Part D: 1 (877) 479-8477
  • Online reporting form

Integrated Care Management referrals

Regence provides a wide range of care management programs and resources designed to support our members at any stage of health. Care management programs are either targeted to specific conditions or designed to improve or maintain overall health. All care management programs are intended to supplement and reinforce the care and guidance you provide to our members.

Learn more about Integrated Care Management services >

Pharmacy-related questions

General inquiries for all products except Medicare Part D and FEP:

  • 1 (800) 643-5918
  • Fax: 1 (800) 884-4282

Pharmacy contracting:

  • Idaho: 1 (800) 632-2022
  • Utah: 1 (800) 632-2022

Pharmacy Prior Authorization:

  • Fax: 1 (800) 884-4282
  • Medicare Part D Fax: 1 (888) 335-3016

Pre-authorization

View our pre-authorization requirements and contact information for each service or supply for our various lines of business. Pre-authorization for dental procedures is not required.

Obtaining pre-authorization information for out-of-area (BlueCard®) members:
Use our online tool to be automatically routed to the home plan's pre-authorization / pre-certification requirements. Launch the tool >

Medical Pre-authorization forms 
Form Description Instructions

Pre-authorization Request Form

Medical, surgical or DME services:

This form is used when a condition requires a pre-authorization. A limited number of services require a pre-authorization.

Expedited is defined as: when the Member or his/her physician believes that waiting for a decision under the standard time frame could place the Member’s life, health, or ability to regain maximum function in serious jeopardy.

Submit completed forms:

  • Securely online, or
  • By Fax to:
    • 1 (877) 663-7526 for Uniform Medical Plan (UMP) members
    • 1 (855) 232-0090 for all other members
    • 1 (855) 240-6498 for requests that meet the definition of expedited

Statement of Medical Necessity for Oncotype DX (PDF)

This form is used to facilitate medical necessity for Oncotype Dx® Breast Cancer Assay. Codes include S3854 and 84999.

Fax completed forms to 1 (855) 232-0090

Behavioral health pre-authorization forms
Form Description Instructions
Behavioral Health Outpatient Treatment Plan Request

This form is for members who require an authorization for behavioral health outpatient treatment, including chemical dependency.

Submit this form to Regence for authorization of continued services through June 30, 2014.

Please call Regence Behavioral Health Customer Service at 1 (888) 496-1540 for any authorization questions. 

  • Complete the Treatment plan request form securely online
  • Download and submit by fax to Regence Behavioral Health at 1 (888) 496-1540:

Provider Customer Service

Our web portals allow you to:

  • Verify patient coverage, benefit types and eligibility effective dates
  • View patient benefit information, including office visit copayments
  • View the status of your submitted claims and payment information
  • Search for and view payment vouchers by provider name, voucher number or check number

Login or register now >

For all other questions that cannot be resolved online, use the contact details below.

Administrative Services Only (ASO) 1 (866) 227-0913
7:00  a.m. to 5:00 p.m.

Federal Employee Program (FEP)

Please note new phone and email options effective September 25, 2013.

1 (877) 668-4657
Monday - Wednesday and Friday: 8:30 a.m. to 4:30 p.m.
Thursday: 9:00 a.m. to 4:30 p.m.

For basic information, please access our web portals as indicated above.

For other (more complex) questions, the following options are available:

  • Select option 1 to receive information about sending an email to our dedicated Provider Support Team.
  • Select option 2 to speak with a live agent.
Healthcare Management Administrators (HMA)

Obtaining pre-authorization, eligibility, claims status or answers to other inquiries:

Submit claims via paper to HMA:

Healthcare Management Administrators, Inc.
P.O. Box 85008
Bellevue, WA 98015

Learn more about HMA >

Regence Group Administrators (RGA)

Obtaining pre-authorization, eligibility, claims status or answers to other inquiries:

Submit claims via paper to RGA:

Regence Group Administrators
P.O. Box 52890
Bellevue, WA 98015-2890

Learn more about RGA >

TriWest/TRICARE

TRICARE Inquiries
Contact UnitedHealthcare Military and Veterans Services for any of the following:

  • Credentialing or contracting questions
  • Claims inquiries for dates of services on or after April 1, 2013
  • TRICARE provider demographic changes (e.g., address, phone or fax number)
Uniform Medical Plan (UMP)

UMP customer service:

  • 1 (888) 849-3682
  • Monday through Friday 7:00 a.m. to 5:00 p.m. PST

Pre-authorization:

  • 1 (888) 849-3682
  • Fax: 1 (877) 663-7526

Learn more about UMP >

Regence Dental Products
Regence EncoreSM, ExpressionsSM and RadianceSM

1 (877) 417-6222
Monday - Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available

Regence Medical Products

Group and Individual

  Regence BluePoint (Core Group) 1 (877) 417-6222
Monday - Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available

  Regence EvolveSM and RealValueSM Individual and Family (Core Individual) 1 (866) 757-3884
Monday - Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available

  Regence HSA Healthplan 2.0SM and HSA Healthplan 3.0SM Phone: 1 (888) 849-0447
Monday - Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available

  Regence Innova® and Engage® and BluePoint (Core Group) 1 (877) 417-6222
Monday - Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available

Medicare

  Regence Bridge Medigap 1 (888) 323-1501
Monday - Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available

  Regence MedAdvantage PPO

1 (877) 508-7362
Monday - Wednesday and Friday: 7 a.m. to 8:00 p.m.
Thursday: 9:00 a.m. to 8:00 p.m.


  Regence BlueAdvantage HMO 1 (855) 522-8898
Monday - Wednesday and Friday: 7 a.m. to 8:00 p.m.
Thursday: 9:00 a.m. to 8:00 p.m.
Other Regence products:
For patients on other Regence products, please call the Core Group or Core Individual phone numbers listed above.

Provider Relations

Provider Relations

Fax: (801) 333-6558

Regence BlueCross BlueShield of Utah
Provider Services Department #26
P.O. Box 30270
Salt Lake City, Utah 84130-0270

Provider Relations Representatives

Our representatives work with providers to resolve issues, acting as a liaison between your office and Regence. Reach out to our team for help with:

  • Contracting questions
  • Provider appeals and grievance process
  • Complex billing and coding information
  • Explanations of specific medical and reimbursement policies
  • Inquiries that cannot be resolved through our web portals or Customer Service

View and print our Provider Relations Representative Territory Map (PDF).

You can also provide anonymous feedback to Provider Relations using our secure feedback form.

  • All counties in Utah (except Tooele and Salt Lake City)
  • Ancillary providers
Cindy Watters
(801) 333-5710
  • Behavioral health – Entire state

Cassady Lessig
1 (800) 643-4512 ext. 5684

  • Dentists and dental professionals
Kimberlee Burfiend
1 (877) 466-3776
  • Intermountain Healthcare (IHC) hospitals and providers
  • Hospital Corporation of America (HCA) hospitals (Brigham City, Lakeview, Mountain View, Ogden Regional, St. Marks, Timpanogos) 
Ramie Davis
(801) 333-5515
  • Tooele and Salt Lake City counties
  • Iasis Hospitals (Davis, Pioneer, Jordan Valley, Salt Lake City Regional)
  • University of Utah hospitals and providers
Melanie Kelaidis
(801) 333-5842

Provider Consultants

Provider consultants are the primary external contact, building relationships with clinics, physician offices and facilities. Consultants support providers by addressing issues and implementing solutions to decrease administrative burden. Consultants can assist with:

  • Electronic tools
  • Strategic initiatives
  • New office orientations
  • Educational workshops
  • Office manager forum participation
  • Office visits requested for problem solving
  • Resolution of global issues (e.g., policies, medical review)

View and print our Provider Consultant Territory Map (PDF).

You can also provide anonymous feedback to Provider Relations using our secure feedback form.

Ancillary Providers

  • All audiologists, ambulance, chiropractic, durable medical equipment, home health, hospice, long-term acute care, optometrists, podiatrists, pharmacy and physical therapy providers
  • Mental health facilities
  • Pathology labs
  • Skilled nursing facilities
Shawnda Estrada
(801) 333-5492
Dentists – Entire state Kimberlee Burfiend
1 (877) 466-3776

Behavioral health – Entire state

Cassady Lessig
1 (800) 643-4512 ext. 5684

Northern Utah

  • Davis County north to Idaho state line: including Box Elder, Cache, Daggett, Davis, Duchesne, Morgan, Rich, Summit, Uintah, Wasatch, and Weber Counties
  • Primary Children’s Medical Center
  • All Intermountain Healthcare (IHC) hospitals and providers
Kim Wood
(801) 333-5560

Northern Salt Lake County and Tooele County 

  • Davis County line to 1300 South
  • Research ParkVeterans Affairs (VA) Hospital
  • Tooele County
  • University of Utah Hospital and Clinics
Stephanie Haws
(801) 333-5714

Southern Salt Lake County

  • 1300 South to Utah County line
  • All Emergency Room groups
  • Iasis Hospitals (Davis, Pioneer, Jordan Valley, Salt Lake Regional)
Sandra Marrero
(801) 333-5974

Southern Utah

  • Beaver, Carbon, Emery, Garfield, Grand, Iron, Juab, Kane, Millard, Piute, San Juan, Sanpete, Sevier, Utah, Washington, Wayne counties
  • Non-clinic affiliated anesthesiologists
  • Hospital Corporation of America (HCA) hospitals (Brigham City, Lakeview, Mountain View, Ogden Regional, St. Marks, Timpanogos)
Shawnda Estrada
(801) 333-5492

 

Receiving secure emails

Emails from Regence staff that contain personal health information are sent securely through Tumbleweed Communications. Please view our secure email (Tumbleweed) troubleshooting guide (PDF) to create an account in order to receive secure emails and, if needed, reset your password.

Regence Medical Policy

Comments from physicians and other health care professionals regarding Regence Medical Policies are welcome. Please complete our secure online contact form.

Regence closure schedule

Our offices will be closed for the following holidays:

2013
Christmas Tuesday and Wednesday

December 24-25 

2014
New Year's Day Wednesday

January 1

President's Day Monday   

February 17

Memorial Day Monday 

May 26

Independence Day Friday July 4
Labor Day Monday   September 1
Thanksgiving Thursday and Friday  November 27-28
Christmas Thursday and Friday 

December 25-26