MEDICAID / PRIMARY CARE NETWORK

The Division of Medicaid and Health Financing manages multiple medical programs for needy individuals in the State of Utah, including Medicaid and the Primary Care Network (PCN) Program. Medicaid administers these programs and encourages electronic data interchange (EDI) as a means to contain administrative costs. This page describes the process for activating your EDI account with Medicaid.
Whether providers are currently sending EDI transactions or wish to start sending transactions, an EDI account must be activated with Medicaid.

Providers must:
1. Become a member of the Utah Health Information Network (UHIN) by
a. Signing UHIN's current Electronic Commerce Agreement, and
b. Obtaining a UHIN Trading Partner Number* (TPN).

2. Complete the Utah Medicaid Provider EDI Enrollment application.

Providers have the responsibility to adequately test all business rules appropriate to the provider type and specialty. When using a third party vendor (clearinghouse), it is the obligation of the trading partner* to ensure the vendor has adequately tested the business rules appropriate to each provider type and specialty.
*A provider submitting EDI transactions is considered a trading partner.