Healthy Preferred Table of Contents · 2020-06-17 · Healthy Preferred General Information ....

Healthy Preferred Table of Contents

GENERAL INFORMATION ..................................................................................................................................................... 6

WELCOME ........................................................................................................................................................................... 7

BIENVENIDOS .................................................................................................................................................................... 10

UNIVERSITY OF UTAH HEALTH PLANS CONTRACTING CRITERIA ......................................................................................... 12

PARTICIPATING FACILITIES & ANCILLARY SERVICES ........................................................................................................... 13

HOSPITALS ................................................................................................................................................................................ 13 HOSPITALS, LONG TERM ACUTE CARE (LTAC) ................................................................................................................................. 13 HOSPITALS, PSYCHIATRIC ............................................................................................................................................................. 13 URGENT CARE CENTERS ............................................................................................................................................................... 13 PUBLIC HEALTH CENTERS / CLINICS ................................................................................................................................................ 14 ADDICTION TREATMENT .............................................................................................................................................................. 14 AMBULATORY BEHAVIORAL HEALTH CLINICS .................................................................................................................................... 15 AMBULATORY SURGERY CENTERS .................................................................................................................................................. 15 CARDIAC MONITORING ............................................................................................................................................................... 16 DIABETES EDUCATION CENTERS .................................................................................................................................................... 16 DIABETES SUPPLY CENTERS .......................................................................................................................................................... 16 DIALYSIS CENTERS ...................................................................................................................................................................... 16 HEARING CENTERS ...................................................................................................................................................................... 17 HOME HEALTH AGENCIES ............................................................................................................................................................ 17 HOME INFUSION SERVICES ........................................................................................................................................................... 18 HOME MEDICAL SUPPLIES / DURABLE MEDICAL EQUIPMENT (DME) ................................................................................................... 19 HOSPICE CARE ........................................................................................................................................................................... 20 INFUSION SUITES ........................................................................................................................................................................ 21 LABORATORY / PATHOLOGY ......................................................................................................................................................... 21 LABORATORY DRAW STATIONS ..................................................................................................................................................... 22 LANGUAGE INTERPRETER SERVICES ................................................................................................................................................ 23 MAMMOGRAPHY SCREENING CENTERS ........................................................................................................................................... 23 RADIOLOGY / IMAGING CENTERS ................................................................................................................................................... 24 REHABILITATION SERVICES............................................................................................................................................................ 24 RESIDENTIAL MENTAL HEALTH FACILITIES ....................................................................................................................................... 25 SKILLED NURSING FACILITIES ......................................................................................................................................................... 25 SLEEP STUDY LABS ...................................................................................................................................................................... 26 VISION CENTERS (OPTICAL SUPPLIERS) ........................................................................................................................................... 26

PARTICIPATING PRIMARY CARE PROVIDERS ...................................................................................................................... 28

ADOLESCENT MEDICINE ............................................................................................................................................................... 28 FAMILY MEDICINE ...................................................................................................................................................................... 28 GENERAL PRACTICE ..................................................................................................................................................................... 55 GERIATRIC MEDICINE .................................................................................................................................................................. 56 HEALTH CENTER/CLINIC .............................................................................................................................................................. 57 INTERNAL MEDICINE ................................................................................................................................................................... 59 MULTISPECIALTY CLINIC ............................................................................................................................................................... 75 OBSTETRICS AND GYNECOLOGY ................................................................................................................................................... 114 PEDIATRICS ............................................................................................................................................................................. 132 PREVENTIVE MEDICINE .............................................................................................................................................................. 152

PARTICIPATING SPECIALTY PROVIDERS ........................................................................................................................... 153


ADDICTION MEDICINE ............................................................................................................................................................... 153 ADVANCED HEART FAILURE AND TRANSPLANT CARDIOLOGY ............................................................................................................. 153 ALLERGY AND IMMUNOLOGY ...................................................................................................................................................... 153 AUDIOLOGY............................................................................................................................................................................. 155 BRAIN INJURY MEDICINE ............................................................................................................................................................ 159 CARDIAC ELECTROPHYSIOLOGY, CLINICAL ...................................................................................................................................... 159 CARDIOLOGY, INTERVENTIONAL................................................................................................................................................... 160 CARDIOTHORACIC SURGERY ........................................................................................................................................................ 161 CARDIOVASCULAR DISEASE ......................................................................................................................................................... 164 CHILD ABUSE PEDIATRICS ........................................................................................................................................................... 169 CHIROPRACTIC ......................................................................................................................................................................... 169 CLINICAL LIPIDOLOGY ................................................................................................................................................................ 172 COLON AND RECTAL SURGERY .................................................................................................................................................... 172 DERMATOLOGY ........................................................................................................................................................................ 172 ELECTRODIAGNOSTIC MEDICINE .................................................................................................................................................. 181 ENDOCRINOLOGY, DIABETES AND METABOLISM ............................................................................................................................. 181 FAMILY MEDICINE .................................................................................................................................................................... 184 FEMALE PELVIC MEDICINE AND RECONSTRUCTIVE SURGERY ............................................................................................................. 185 FOOT AND ANKLE SURGERY ........................................................................................................................................................ 185 GASTROENTEROLOGY ................................................................................................................................................................ 185 GENETIC COUNSELING ............................................................................................................................................................... 190 GENETICS AND GENOMICS, CLINICAL ............................................................................................................................................ 191 HAND SURGERY ....................................................................................................................................................................... 192 HEMATOLOGY.......................................................................................................................................................................... 193 HEMATOLOGY/ONCOLOGY......................................................................................................................................................... 195 HOSPICE AND PALLIATIVE MEDICINE ............................................................................................................................................ 198 INFECTIOUS DISEASE ................................................................................................................................................................. 199 INTERNAL MEDICINE ................................................................................................................................................................. 199 MATERNAL AND FETAL MEDICINE ................................................................................................................................................ 202 MIDWIFERY ............................................................................................................................................................................. 204 MULTISPECIALTY CLINIC ............................................................................................................................................................. 204 NEPHROLOGY .......................................................................................................................................................................... 206 NEURODEVELOPMENTAL DISABILITIES........................................................................................................................................... 212 NEUROLOGICAL SURGERY........................................................................................................................................................... 212 NEUROLOGY ............................................................................................................................................................................ 215 NEUROLOGY WITH SPECIAL QUALIFICATION IN CHILD NEUROLOGY ..................................................................................................... 219 NEUROMUSCULAR MEDICINE ..................................................................................................................................................... 220 NEUROPHYSIOLOGY, CLINICAL ..................................................................................................................................................... 220 NEUROTOLOGY ........................................................................................................................................................................ 221 NUCLEAR CARDIOLOGY .............................................................................................................................................................. 221 NUCLEAR RADIOLOGY ............................................................................................................................................................... 222 NURSE PRACTITIONER ............................................................................................................................................................... 222 NURSE PRACTITIONER, PSYCHIATRIC-MENTAL HEALTH .................................................................................................................... 222 OBSTETRICS AND GYNECOLOGY ................................................................................................................................................... 222 OCCUPATIONAL MEDICINE ......................................................................................................................................................... 223 OCCUPATIONAL THERAPY ........................................................................................................................................................... 224 ONCOLOGY, GYNECOLOGIC ........................................................................................................................................................ 229 ONCOLOGY, MEDICAL ............................................................................................................................................................... 230 ONCOLOGY, SURGICAL .............................................................................................................................................................. 232


OPHTHALMOLOGY .................................................................................................................................................................... 232 OPTOMETRY ............................................................................................................................................................................ 240 ORAL AND MAXILLOFACIAL SURGERY ........................................................................................................................................... 245 ORTHOPAEDIC SPORTS MEDICINE ................................................................................................................................................ 247 ORTHOPEDICS/ORTHOPAEDIC SURGERY........................................................................................................................................ 248 OTOLARYNGOLOGY (ENT) ......................................................................................................................................................... 258 PAIN MEDICINE ....................................................................................................................................................................... 263 PEDIATRIC CARDIOLOGY............................................................................................................................................................. 268 PEDIATRIC DERMATOLOGY ......................................................................................................................................................... 272 PEDIATRIC ENDOCRINOLOGY ....................................................................................................................................................... 272 PEDIATRIC GASTROENTEROLOGY ................................................................................................................................................. 273 PEDIATRIC HEMATOLOGY-ONCOLOGY .......................................................................................................................................... 275 PEDIATRIC INFECTIOUS DISEASES ................................................................................................................................................. 276 PEDIATRIC NEPHROLOGY ........................................................................................................................................................... 276 PEDIATRIC NEUROLOGICAL SURGERY ............................................................................................................................................ 277 PEDIATRIC OTOLARYNGOLOGY .................................................................................................................................................... 277 PEDIATRIC PULMONOLOGY ......................................................................................................................................................... 278 PEDIATRIC REHABILITATION MEDICINE ......................................................................................................................................... 278 PEDIATRIC RHEUMATOLOGY ....................................................................................................................................................... 278 PEDIATRIC SLEEP MEDICINE ........................................................................................................................................................ 279 PEDIATRIC SPORTS MEDICINE ..................................................................................................................................................... 279 PEDIATRIC SURGERY .................................................................................................................................................................. 279 PEDIATRIC TRANSPLANT HEPATOLOGY .......................................................................................................................................... 282 PEDIATRIC UROLOGY ................................................................................................................................................................. 282 PEDIATRICS ............................................................................................................................................................................. 283 PEDIATRICS, DEVELOPMENTAL-BEHAVIORAL .................................................................................................................................. 285 PHYSICAL MEDICINE AND REHABILITATION .................................................................................................................................... 285 PHYSICAL THERAPY ................................................................................................................................................................... 288 PLASTIC SURGERY ..................................................................................................................................................................... 309 PLASTIC SURGERY WITHIN THE HEAD AND NECK ............................................................................................................................ 310 PODIATRY ............................................................................................................................................................................... 311 PULMONARY DISEASE................................................................................................................................................................ 314 RADIATION ONCOLOGY ............................................................................................................................................................. 317 RADIOLOGY, INTERVENTIONAL AND DIAGNOSTIC ............................................................................................................................ 319 RADIOLOGY, VASCULAR AND INTERVENTIONAL ............................................................................................................................... 319 REGISTERED DIETITIAN/NUTRITION PROFESSIONAL ......................................................................................................................... 319 REPRODUCTIVE ENDOCRINOLOGY/INFERTILITY ............................................................................................................................... 320 RHEUMATOLOGY ...................................................................................................................................................................... 321 SLEEP MEDICINE ...................................................................................................................................................................... 323 SPEECH-LANGUAGE PATHOLOGY ................................................................................................................................................. 323 SPINAL CORD INJURY MEDICINE .................................................................................................................................................. 327 SPORTS MEDICINE .................................................................................................................................................................... 327 SURGERY, GENERAL .................................................................................................................................................................. 328 TRANSPLANT HEPATOLOGY ........................................................................................................................................................ 334 UROLOGY ............................................................................................................................................................................... 334 VASCULAR NEUROLOGY ............................................................................................................................................................. 338 VASCULAR SURGERY ................................................................................................................................................................. 338 WOUND CARE/HYPERBARIC MEDICINE ........................................................................................................................................ 340

PARTICIPATING BEHAVIORAL HEALTH PROVIDERS .......................................................................................................... 341


ADDICTION PSYCHIATRY ............................................................................................................................................................. 341 AUTISM .................................................................................................................................................................................. 341 BEHAVIOR ANALYSIS ................................................................................................................................................................. 347 COUNSELING ........................................................................................................................................................................... 348 GERIATRIC PSYCHIATRY .............................................................................................................................................................. 357 MARRIAGE AND FAMILY THERAPY ................................................................................................................................................ 357 MENTAL HEALTH SERVICES ........................................................................................................................................................ 359 NEUROPSYCHOLOGY ................................................................................................................................................................. 360 PSYCHIATRY............................................................................................................................................................................. 362 PSYCHIATRY, CHILD AND ADOLESCENT .......................................................................................................................................... 367 PSYCHOLOGY ........................................................................................................................................................................... 369 PSYCHOLOGY, CHILD AND ADOLESCENT ........................................................................................................................................ 376 PSYCHOSOMATIC MEDICINE ....................................................................................................................................................... 376 SOCIAL WORK ......................................................................................................................................................................... 376

INDEX OF PROVIDERS BY LANGUAGES SPOKEN ............................................................................................................... 393

INDEX .............................................................................................................................................................................. 452

Healthy Preferred General Information

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Directories are subject to change. Members may be responsible for out-of-pocket expenses if a provider is non-participating. Members are encouraged to confirm that a provider is participating with their plan, prior to scheduling an appointment. If you have questions or need a translator, please contact our Customer Service Department at 1-833-981-0213 for Group Plans or 1-833-981-0214 for Individual Plans.

University of Utah Health Plans uhealthplan.utah.edu

General Information My Doctors: Name:

Phone:

Name:

Phone:

Name:

Phone: U of U Health Plans Customer Service: Phone:

Group Plans: 801-213-4008 or 1-833-981-0213 Individual Plans: 801-213-4111 or 1-833-981-0214

Hours: Mon – Fri, 8 AM – 6 PM

Email: [email protected] Fax: 801-281-6121 U of U Health Plans Website Address: uhealthplan.utah.edu U of U Health Plans Claims: Phone:

Group Plans: 801-213-4008 or 1-833-981-0213, option 1 Individual Plans: 801-213-4111 or 1-833-981-0214, option 1 Mail to: P.O. Box 45180 Salt Lake City, UT 84145-0180 U of U Health Plans Care Management: Phone:

Group Plans: 801-213-4008 or 1-833-981-0213, option 2 Individual Plans: 801-213-4111 or 1-833-981-0214, option 2

Because providers may be added to or deleted from University of Utah Health Plans at any time, please verify that providers are in your plan network by calling University of Utah Health Plans Customer Service at 1-833-981-0213 for Group Plans or 1-833-981-0214 for Individual Plans.

https://uhealthplan.utah.edu/mailto:[email protected]://uhealthplan.utah.edu/

Healthy Preferred Welcome

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WELCOME TO HEALTHY PREFERRED This directory lists the providers in the Healthy Preferred network. You will have the lowest out-of-pocket cost when you receive services from these providers.

Choosing Your Doctor: A Primary Care Physician (PCP) is a doctor you see for most of your medical care. Healthy Preferred PCPs are listed in the front of this handbook. You do not have to pick a PCP; but we think you should. A PCP will: • See you for routine check-ups. • Treat you when you are sick or injured. • Refer you to a specialist (if needed). • Approve all non-emergency hospital stays. • Be your contact if you need care after office

hours (except emergencies). Choose a PCP from the list of providers in this directory. These are the kinds of doctors who are PCPs: • Family or General Practice (for all ages) • Internal Medicine (for adults) • Pediatrician (for children) • Obstetrics and Gynecology (OB/GYN – for

women). You may also choose a Certified Nurse Midwife (CNM) if you are having a baby.

You may select one PCP for your whole family or a different PCP for every family member with Healthy Preferred as their health plan. If you have a special health need, you may be able to choose a specialist as your PCP. A Case Manager will work with you to choose a specialist as your PCP. Our Case Managers are Registered Nurses. They will work with you and your doctor(s) to make sure you get the care you need. The Healthy Preferred plan provides access to providers and facilities for covered services under your benefit plan. Providers and facilities were selected based on our specific criteria for cost and quality. We survey our members periodically to determine member satisfaction. We look at the number of providers and facilities in the counties where our plans provide coverage to members. We make sure that members can access our providers

and facilities within a reasonable driving distance and/or time. Remember: Go to the emergency room if you have an Emergency Medical Condition that requires Emergency Service. Do not go to the emergency room, though, for routine medical care. If you think your medical problem might be an emergency, call 911 or go to any hospital emergency room. “Emergency Medical Condition” means, unless otherwise defined in an applicable Benefit Plan, a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that a prudent layperson, who possesses an average knowledge of medicine and health, could reasonably expect the absence of immediate medical attention to result in: (a) placing the patient’s health (or, with respect to a pregnant woman, the health of a woman or her unborn child) in serious jeopardy; (b) serious impairment of bodily function; (c) serious dysfunction of any bodily organ or part. Severe bleeding, unconsciousness, and fracture are examples of Emergencies. The determination of whether Emergency Services are Covered Services shall rest with University. Such determination shall be consistent with the definition of “Emergency Medical Condition” as stated above and shall be subject to the appeals process of University. Notwithstanding any other provision in this Agreement, University shall not deny payment for Emergency Services provided by Provider to Members in accordance with USC 42, Section 1395 et seq of the Emergency Medical Treatment and Active Labor Act (EMTALA). “Emergency Services” means covered inpatient and outpatient services that are furnished by a Provider that is qualified to furnish these services and that are needed to evaluate or stabilize an Emergency Medical Condition. For questions about your medical benefits, please call Member Services at 1-833-981-0213 for Group Plans or 1-833-981-0214 for Individual Plans.


06/12/2020 Page 8


Important Phone Numbers: Member Services:

Group Plans: 801-213-4008 or 1-833-981-0213

Individual Plans: 801-213-4111 or 1-833-981-0214 Hours:

Mon-Fri: 8 a.m. - 6 p.m. U of U Physician Referral Service: 801-581-2897 U of U Health Plan members can call our Access Assistance line to help find a provider, transition to an in-network provider or schedule an appointment. To contact a care coordinator, call 1-833-981-0213, option 2 for Group Plans or 1-833-981-0214, option 2 for Individual Plans. Healthy Preferred on the Internet: https://uhealthplan.utah.edu/ Claims may be mailed to: HEALTHY PREFERRED Attn: Claims Department P.O. Box 45180 Salt Lake City, UT 84145

https://uhealthplan.utah.edu/


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Healthy Preferred has translators for any language. Please call member services at 1-833-981-0214.

If you have diabetes, heart disease, arthritis or any other chronic condition, Healthy Preferred has a Care Manager ready to assist you to make sure you get the care that you need. Give our Care Management department a call at 801-213-4111, option 2 or 1-833-981-0214, option 2.

Spanish ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-833-981-0214.

Chinese 注意：如果您使用繁體中文，您可以免費獲得語

言援助服務。請致電 1-833-981-0214。

Vietnamese CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-833-981-0214.

Korean 주의: 한국어를 사용하시는 경우, 언어 지원

서비스를 무료로 이용하실 수 있습니다. 1-833-

981-0214 번으로 전화해 주십시오.

Navajo Díí baa akó nínízin: Díí saad bee yáníłti’go Diné Bizaad, saad bee áká’ánída’áwo’dęę’, t’áá jiik’eh, éí ná hólǫ, kojį’ hódíílnih 1-833-981-0214

Nepali �ान िदनुहोस्: तपाइ�ले नेपाली बोल्नु�न्छ भने तपाइ�को िन�� भाषा सहायता सेवाह� िनःशु� �पमा उपल� छ । फोन गनु�होस् 1-833-981-0214

Tongan FAKATOKANGA’I: Kapau ‘oku ke Lea-Fakatonga, ko e kau tokoni fakatonu lea ‘oku nau fai atu ha tokoni ta’etotongi, pea teke lava ‘o ma’u ia. Telefoni mai 1-833-981-0214

Serbo-Croatian OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite 1-833-981-0214

Tagalog PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-833-981-0214

German ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-833-981-0214

Russian ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-833-981-0214

Cambodian ្របយ័ត�៖ េបើសិន�អ�កនិ�យ ��ែខ�រ, េស�ជំនួយែផ�ក�� េ�យមិនគិតឈ� �ល គឺ�ច�នសំ�ប់បំេរ �អ�ក។ ចូរ ទូរស័ព� 1-833-981-0214

French ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-833-981-0214

Japanese 注意事項：日本語を話される場合、無料の言語

支援をご利用いただけます。1-833-981-0214

Arabic اللغویة المساعدة خدمات فإن ،اللغة اذكر تتحدث كنت إذا :ملحوظة 0214-981-833-1 برقم اتصل .بالمجان لك تتوافر

Healthy Preferred Bienvenidos

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BIENVENIDOS A HEALTHY PREFERRED Este directorio enumera a los proveedores en la red de Healthy Preferred. Usted tendrá el más bajo de los gastos de bolsillo cuando recibe servicios de estos proveedores. Escogiendo a Su Doctor: Un Médico de Atención Primaria (PCP) es un doctor al que usted ve en la mayoría de sus atenciones médicas. Los PCP de Healthy Preferred aparecen en la parte de atrás de este manual. No tiene que escoger a un PCP, pero creemos que debería. Un PCP realizará lo siguiente: • Lo verá para chequeos de rutina. • Lo atenderá cuando esté enfermo o lesionado. • Lo referirá a un especialista (de ser necesario). • Aprobará todas las hospitalizaciones que no

sean de emergencia. • Será su contacto si necesita que lo atiendan

fuera del horario del consultorio (excepto las emergencias).

Escoja a un PCP de la lista de proveedores que aparece en este manual. Estas son las clases de doctores que son PCP: • Práctica Familiar (para todas las edades) • Medicina Interna (para adultos) • Pediatría (para niños) • Obstetricia y Ginecología (OB/GYN – para

mujeres). También puede escoger una Enfermera Obstétrica Certificada (CNM) si va a tener un bebé.

Puede escoger a un PCP para toda su familia, o un PCP diferente para cada miembro de la familia que tiene Healthy Preferred como su plan de salud. Si tiene una necesidad especial de salud, puede escoger a un especialista como su PCP. Un Administrador de Caso trabajará con usted para escoger a un especialista como su PCP. Nuestros Administradores de Caso son Enfermeras Registradas. Ellas trabajarán con usted y su doctor(es) para asegurarse de que usted reciba la atención que necesita.

El plan Healthy Preferred proporciona acceso a los proveedores y las instalaciones para los servicios cubiertos por su plan de beneficios. Se seleccionaron los proveedores y las instalaciones en

base a los criterios específicos de costo y calidad. Hacemos encuestas a nuestros miembros periódicamente para determinar la satisfacción de los miembros. Nos fijamos en el número de proveedores e instalaciones en los condados donde nuestros planes proporcionan cobertura a los miembros. Nos aseguramos de que los miembros puedan acceder a nuestros proveedores e instalaciones dentro de una razonable distancia o tiempo.

Recuerde: Vaya a la sala de emergencias si tiene una a condición médica de emergencia que requiere un servicio de emergencia. No vaya a la sala de emergencia si se trata de una atención médica de rutina. Si usted piensa que su problema médico puede ser una emergencia, llame al 911 o vaya a la sala de emergencia de cualquier hospital.

“Condición de Emergencia Médica” significa a menos que se defina lo contrario en un Plan de Beneficios aplicable, una condición médica que se manifiesta por síntomas agudos de suficiente gravedad, incluyendo dolor severo. De tal manera que un laico prudente, que posee un conocimiento promedio de medicina y salud, podría razonablemente esperar que la ausencia de atención médica inmediata resulte en: (a) poner en grave peligro la salud del paciente (o, con respecto a una mujer embarazada, la salud de una mujer o su feto); (b) deterioro grave de la función corporal; (c) disfunción grave de cualquier órgano o parte del cuerpo. El sangrado severo, la inconsciencia y fracturas son ejemplos de emergencias. La determinación de si los Servicios de Emergencia son Servicios Cubiertos dependerá de la Universidad. Dicha determinación deberá ser consistente con la definición de “Condición de Emergencia Médica” como se indicó anteriormente y estará sujeto al proceso de apelación de la Universidad. No obstante, cualquier otra disposición en este Acuerdo, la Universidad no negará el pago por los Servicios de Emergencia proporcionados por el Proveedor a los Miembros de conformidad con la USC 42, Sección 1395 y siguientes de la Ley de Tratamiento Médico de Emergencia y Trabajo Activo (EMTALA).

"Servicios de Emergencia" se refiere a los servicios

Healthy Preferred Bienvenidos

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cubiertos para pacientes hospitalizados y ambulatorios que proporciona un proveedor que está calificado para brindar estos servicios y que son necesarios para evaluar o estabilizar una condición médica de emergencia.

Si tiene preguntas respecto de sus beneficios médicos, llame a los Servicios para Miembros al 1-833-981-0213 para Planes Grupaleso o 1-833-981-0214 para Planes Individuales. Números Telefónicos Importantes: Servicios Para Miembros:

Planes Grupaleso: 801-213-4008 o 1-833-981-0213

Planes Individuales: 801-213-4111 o 1-833-981-0214 Horario:

lunes - viernes: 8:00 a.m.- 6:00 p.m. U de U Servicio de Referencia Médica: 801-581-2897 Los miembros de U of U Health Plan pueden llamar a nuestra línea de Asistencia de Acceso para ayudar a encontrar un proveedor, hacer la transición a un proveedor dentro de la red o programar una cita. Para comunicarse con un coordinador de atención, llame al 1-833-981-0213, opción 2 para Planes Grupaleso o 1-833-981-0214, opción 2 para Planes Individuales. Healthy Preferred en Internet: https://uhealthplan.utah.edu/ Envíe sus reclamos a: HEALTHY PREFERRED Attn: Claims Department P.O. Box 45180 Salt Lake City, UT 84145

Healthy Preferred tiene traductores para cualquier idioma. Por favor, llame a Servicios para Miembros al 1-833-981-0213 para Planes Grupaleso o 1-833-981-0214 para Planes Individuales. Si usted tiene diabetes, enfermedades del corazón, artritis o cualquier otra enfermedad crónica, Healthy Preferred tiene un Administrador de Atención disponible para ayudarle y para asegurarse de que usted reciba la atención médica que necesita. Llame a nuestro departamento de Administración de la Atención al 1-833-981-0213, opción 2 para Planes Grupaleso o 1-833-981-0214, opción 2 para Planes Individuales.

https://uhealthplan.utah.edu/

Healthy Preferred University of Utah Health Plans Contracting Criteria

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The University of Utah Health Plans (UUHP) contracts with physicians and other health care professionals and facilities for all of our product lines, including commercial, marketplace, and Medicaid, to offer provider networks essential to the delivery of health care and services to our members. UUHP is committed to the “triple aim” of improving experience and quality of care, improving the health of populations, and reducing the per capita cost of care.

We recognize the importance of population health and payment reform and have developed extensive care management and value-based payment programs that improve health and align provider reimbursement with value and positive outcomes.

Provider applications to participate in any UUHP network are considered based on the following:

UUHP business needs which may include and are not limited to: • Network adequacy requirements based on state and/or federal guidelines • Network adequacy requirements based on the current or expected population of a given

geographic area (usually defined by county or zip code) • Network adequacy requirements based on provider type and/or specialty • Network composition based on scope of services required by payer such as employer, health

plan, union/trust, government entity, etc. • Demographic needs including but not limited to languages spoken • Existing, non-compensated, referral patterns with current network providers and/or UUHP

members

Quality, patient experience and cost data as available which may include and is not limited to:

• Comparisons of provider practice data to benchmark market averages related to compliance with industry-standard quality measures. Examples include: Hemoglobin A1c (HbA1c) testing in diabetic patients, breast cancer screening prevention rates, and child immunization rates.

• Industry published and available patient surveys and reviews • Comparisons of provider practice cost data to benchmark market averages on a per-member-

per-month basis for similar populations

The credentialing process which may include and is not limited to, verifying appropriate licensure, education and training, board certification, DEA licensure, accreditation/certification status, review of sanctions and a review of an acceptable history of professional liability claims.

All providers must be approved through our credentialing process before they may participate in any network.

UUHP plans are designed based on specific criteria that we apply to select participating primary care physicians and specialists which include:

• Cardiology • General Surgery • Neurology • Urology • Orthopedics • Obstetrics and Gynecology

Additional primary care physicians, specialists, and facilities are included if they meet our credentialing requirements to ensure members have access within a reasonable distance to the number and types of providers needed.

Healthy Preferred Participating Facilities & Ancillary Services

06/12/2020 Page 13

Directories are subject to change. Members may be responsible for out-of-pocket expenses if a provider is non-participating. Members are encouraged to confirm that a provider is participating with their plan, prior to scheduling an appointment. If you have questions or need a translator, please contact our Customer Service Department at 1-833-981-0213 for Group Plans or 1-833-981-0214 for Individual Plans. ♿ ADA accesible - For specific accommodations contact the provider ㏄ Cultural Competency training

Hospitals Bountiful Lakeview Hospital ♿

630 E Medical Dr .......... (801) 299-2200

Brigham City Brigham City Community Hospital ♿

950 S Medical Dr .......... (435) 734-9471

Draper Lone Peak Hospital ♿

11925 S State St ........... (801) 545-8000

North Logan Cache Valley Hospital ♿

2380 N 400 E ................ (435) 713-9700

Ogden Ogden Regional Medical Center ♿

5475 S 500 E ................. (801) 479-2111

Orem Timpanogos Regional Hospital ♿

750 W 800 N ................ (801) 714-6000

Payson Mountain View Hospital ♿

1000 E 100 N ................ (801) 465-7000

Riverton Primary Children's Unit at Riverton

Hospital ♿ 3741 W 12600 S ........... (801) 285-4000

Salt Lake City Huntsman Cancer Institute ♿

2000 Cir Of Hope .......... (801) 585-0303 Primary Children's Hospital ♿

100 N Mario Capecchi Dr ............................... (801) 662-1000

Shriners Hospitals for Children ♿ 1275 E Fairfax Rd.......... (801) 536-3500

St. Mark's Hospital ♿ 1200 E 3900 S ............... (801) 268-7111

University of Utah Hospital ♿ ㏄ 50 N Medical Dr ........... (801) 581-2121

UUHC University Orthopaedic Center ♿ ㏄ 590 Wakara Way .......... (801) 587-7109

Taylorsville St. Mark's Taylorsville Emergency Center

♿ 5400 S 2700 W ............. (801) 982-0050

Hospitals, Long Term Acute Care (LTAC) Bountiful Western Peak Specialty Hospital

485 E 500 S .................. (801) 397-8177

Murray KPC Promise Hospital of Salt Lake

4252 Birkhill Blvd ......... (801) 408-7100

Provo Utah Valley Specialty Hospital

306 West Riv Bnd Ln .... (801) 226-8880

Hospitals, Psychiatric Bountiful Lakeview Hospital ♿

630 E Medical Dr .......... (801) 299-2200

Orem Provo Canyon Behavioral Hospital ♿

1350 E 750 N ................ (801) 852-2273

Salt Lake City St. Mark's Hospital ♿

1200 E 3900 S .............. (801) 268-7111 University Neuropsychiatric Institute

(UNI) ♿ ㏄ 501 Chipeta Way.......... (801) 583-2500

University of Utah Hospital ♿ ㏄ 50 N Medical Dr ........... (801) 581-2121

West Jordan Jordan Valley Medical Center ♿

3580 W 9000 S ............. (801) 561-8888

West Valley City Jordan Valley Medical Center - West

Valley Inpatient Psych ♿ 3460 S Pioneer Pkwy ... (801) 964-3100

Urgent Care Centers American Fork Medallus Medical - American Fork

476 N 900 W Ste C ....... (801) 492-1611

Bountiful FirstMed Urgent Care - North

1512 Renaissance Towne Dr Ste 100 ......................... (801) 295-6483

Ogden Clinic - Cope Family Medicine Urgent Care 185 S 400 E Ste 100...... (801) 397-6200

Centerville UUHC Centerville Health Center - Urgent

Care ♿ ㏄ 26 S Main St ................. (801) 213-8844

Cottonwood Heights FirstMed Urgent Care - East

1950 E 7000 S ............... (801) 943-3300

Draper Medallus Medical - Draper

1126 E 12300 S ............. (801) 545-0600

Eagle Mountain Eagle Mountain Family Medicine &

Urgent Care - Revere Health 4095 E Pony Expy Pkwy Ste 1.............................. (801) 429-8037

Farmington Ogden Clinic - Farmington Urgent Care

991 W Shepard Ln ........ (801) 397-6080 UUHC Farmington Health Center - Urgent

Care ♿ ㏄ 165 N University Ave .... (801) 213-3200

Farr West Revere Health Family medicine

2850 N 2000 W Ste 101.......................... (801) 528-5094

Hailey, ID Sterling Urgent Care - Hailey

507 S Main St ................ (208) 788-4122

Holladay Medallus Medical - Holladay

3934 S 2300 E Ste D ...... (801) 849-8500

Idaho Falls, ID Sterling Urgent Care - Idaho Falls

740 S Woodruff Ave ..... (208) 542-9111

Layton Medallus Medical - Layton

1868 N 1200 W ............. (801) 614-9030 Ogden Clinic - Davis Family Physicians

Urgent Care 3225 W Gordon Ave ..... (801) 397-6150

Wee Care Pediatrics - Layton Office ♿ 2084 N 1700 W Ste A .... (801) 773-8644

Logan Sterling Urgent Care - Logan

1201 S Main St Ste 110.......................... (435) 787-8504

Sterling Urgent Care - North Logan 630 E 1400 N Ste 150 ... (435) 915-4465

Magna Exodus Healthcare Network - Magna

Health Center 3665 S 8400 W Ste 110.......................... (801) 250-9638


06/12/2020 Page 14


Midvale UUHC Greenwood Health Center -

Urgent Care ♿ 7495 S State St ............. (801) 213-8840

Mt. Pleasant Mt. Pleasant Family Medicine & Urgent

Care - Revere Health 1075 South Hwy 89 ...... (435) 462-2044

Murray FirstMed Urgent Care - Murray

5911 S Fashion Pl Blvd ............................ (801) 266-6843

Ogden Ogden Clinic - Canyon View Urgent Care

1159 E 12Th St ............. (801) 475-3700 Ogden Clinic - Professional Center Urgent

Care 4650-4700 South

Harrison Blvd ............. (801) 475-3000 Ogden Clinic - Skyline Urgent Care

6112 S 1550 E ............... (801) 475-3800 Ogden Clinic - South Ogden Center for

Family Medicine Urgent Care 5740 Crestwood Dr ...... (801) 479-7771

Orem UUHC Parkway Health Center - Urgent

Care ♿ ㏄ 145 W University

Pkwy........................... (801) 234-8585

Park City Stat MD Urgent Care Park City

1784 W Uinta Way Ste E-2 .......................... (435) 604-0160

UUHC Redstone Health Center - Urgent Care ♿ ㏄ 1743 W Redstone Ctr Dr Ste 115 ......................... (435) 658-9262

Payson Payson Family Medicine & Urgent Care -

Revere Health 97 Professional Way Ste 2 ............................. (801) 465-4896

Pleasant View Ogden Clinic - Mountain View Urgent

Care 1100 W 2700 N ............ (801) 475-3600

Provo Provo Family Medicine & Urgent Care -

Revere Health 1055 N 500 W Bldg A ... (801) 812-5033

Riverwoods Urgent Care ♿ 280 W Riverpark Dr Ste 120 ......................... (801) 229-2011

Riverton Granger Medical Riverton - Urgent Care

12391 S 4000 W ........... (801) 302-1700 Medallus Medical - South Bangerter

13348 S Market Ctr Dr Ste 100 ......................... (801) 844-1600

Roy Ogden Clinic - Grand View Urgent Care

3485 N 5200 S .............. (801) 475-3900 Roy Rock Run Family Medicine & Urgent

Care - Revere Health 5640 S 3500 W ............. (801) 773-2838

Salem Salem Urgent Care - Revere Health

555 W Sr 164 N ............ (801) 465-4896

Salt Lake City FirstMed Urgent Care - Central ♿ ㏄

441 S Redwood Rd ....... (801) 973-2588 Revere Health - Clinton

1407 N 2000 W Ste C ... (801) 866-0170 University of Utah Hospital - Urgent Care

♿ ㏄ 50 N Medical Dr ........... (801) 581-2121

UUHC Orthopaedic Center Injury Clinic ♿ ㏄ 590 Wakara Way.......... (801) 587-7109

UUHC Redwood Health Center - Urgent Care ♿ ㏄ 1525 W 2100 S ............. (801) 213-9900

Sandy Medallus Medical - Sandy

7998 S 1300 E .............. (801) 255-2000

South Jordan Copperview Medical Center ♿ ㏄

3556 W 9800 S Ste 101 ......................... (801) 567-9780

Medallus Medical - South Jordan 10433 S Redwood Rd ... (801) 501-0500

UUHC South Jordan Health Center - Urgent Care ♿ ㏄ 5126 W Daybreak

Pkwy .......................... (801) 213-4500

St. George St. George Clinic Urgent Care - Revere

Health 736 S 900 E Ste 203...... (435) 673-6131

Stansbury Park Tooele Valley Urgent Care

1244 N Main St Ste 201.......................... (435) 882-3968

Washington Washington Family Medicine & Urgent

Care - Revere Health 195 W Telegraph St ...... (435) 215-0600

West Jordan FirstMed Urgent Care - West Jordan

8822 S Redwood Rd Ste E-122 ...................... (801) 256-0009

Granger Medical West Jordan - Urgent Care 3181 W 9000 S.............. (801) 352-5900

Stat MD Urgent Care West Jordan 7724 S 5600 W Ste 102.......................... (801) 432-8480

West Valley City Granger Medical West Valley - Urgent

Care 3725 W 4100 S.............. (801) 965-3600

Medallus Medical - West Valley 3451 S 5600 W Ste F ..... (801) 957-0900

UUHC Westridge Health Center - Urgent Care ♿ 3730 W 4700 S.............. (801) 213-8843

Public Health Centers / Clinics Bountiful Davis County Health Department ♿

596 W 750 S.................. (801) 525-4979

Clearfield Davis County Health Department ♿

22 S State St .................. (801) 525-5020

Ogden Weber-Morgan Health Department ♿

477 23rd St ................... (801) 399-7252

Addiction Treatment Orem Nexstep Medical Detox ♿

1429 N 1200 W ............. (801) 607-1189

Sandy AD Psychotherapy and Clinical Consulting

8465 S 700 E ................. (801) 233-8577


06/12/2020 Page 15


Ambulatory Behavioral Health Clinics American Fork Wasatch Behavioral Health - American

Fork Family Clinic ♿ 578 E 300 S ................... (801) 763-5010

Clearfield Davis Behavioral Health - Clearfield ♿

129 S State St Ste 240 .. (801) 336-1839 Davis Behavioral Health - Clearfield

860 S State St ............... (801) 776-7060 Davis Behavioral Health - Clearfield

904 S State St ............... (801) 773-7060

Harrisville Aloha Behavioral Consultants ♿ ㏄

811 N Harrisville Rd ...... (801) 399-1818

Heber City Wasatch Behavioral Health - County

Family Clinic 55 S 500 E ..................... (435) 654-3003

Layton Ascendant Behavioral Health - Layton

1133 N Main Ste 128 .... (801) 872-5516 Davis Behavioral Health - CRU, Journey

House, WRC, MRC 2250 N 1700 W ............ (801) 773-7060

Davis Behavioral Health - Main Street Clinic 934 S Main St ............... (801) 773-7060

Lehi Ascendant Behavioral Health - Lehi

3051 W Maple Loop Dr Ste 210 ......................... (801) 872-5516

Millcreek Odyssey House - Millcreek Residential

3944 S 400 E ................. (801) 322-3222

Murray Odyssey House - Meadowbrook

61 W 3900 S ................. (801) 322-3222

Ogden Weber Human Services - Ogden ♿

237 26th St ................... (801) 625-3700

Orem Wasatch Behavioral Health - Aspire

Academy ♿ 371 S Vineyard Rd ........ (801) 960-1680

Payson Wasatch Behavioral Health - Payson

Family Clinic ♿ 285 N 1250 E ................ (801) 852-3805

Provo Project Reality - Provo

151 S University Ave Ste 1400 ....................... (801) 851-7118

Wasatch Behavioral Health - Intensive Residential Treatment ♿ 1157 E 300 N ................ (801) 377-4668

Wasatch Behavioral Health - Mountain Peaks Counseling Clinic ♿ 580 E 600 S Ste 210...... (801) 960-1620

Wasatch Behavioral Health - New Vista ♿ 1161 E 300 N ................ (801) 375-9226

Wasatch Behavioral Health - Parkview ♿ 1161 E 300 N ................ (801) 373-4765

Wasatch Behavioral Health - Provo 1175 E 300 N ................ (801) 373-7393

Wasatch Behavioral Health - Provo Family Clinic ♿ 1165 E 300 N ................ (801) 377-1213

Wasatch Behavioral Health - Vantage Point ♿ 1189 E 300 N ................ (801) 373-2215

Wasatch Behavioral Health - Watch ♿ 299 E 900 S .................. (801) 852-3779

Wasatch Behavioral Health - Wellness Recovery Center 580 E 600 S 2nd Fl ........ (801) 852-3789

Wasatch Behavioral Health - Westpark ♿ ㏄ 750 Freedom Blvd ........ (801) 373-4760

Salt Lake City Ascendant Behavioral Health - Salt Lake

5383 S 900 E Ste 103.... (801) 872-5516 Center for Family Evaluation and

Treatment - Taylorsville ♿ 5691 S Redwood Rd Ste 16 A ........................ (801) 265-3895

Odyssey House - Adolescent Day Treatment 607 E 200 S .................. (801) 322-3222

Odyssey House - Adolescent Residential Treatment 607 E 200 S .................. (801) 322-3222

Odyssey House - Adult Day Treatment 68 S 600 E .................... (801) 322-3222

Odyssey House - Adult Outpatient and Transitional Services 344 E 100 S .................. (801) 322-3222

Odyssey House - Adult Residential Treatment 68 S 600 E .................... (801) 322-3222

Odyssey House - Anchor East Transitional Housing 218 E 4500 S ................ (801) 322-3222

Odyssey House - Anchor West Transitional 174 E 4500 S ................. (801) 322-3222

Odyssey House - Annex Residential Support 62 S 200 E ..................... (801) 322-3222

Odyssey House - Boarding House 346 E 100 S ................... (801) 322-3222

Odyssey House - Children's Service Day Treatment 340 E 100 S ................... (801) 322-3222

Odyssey House - Fathers with Children 623 S 200 E ................... (801) 322-3222

Odyssey House - Lighthouse 745 E 300 S ................... (801) 322-3222

Odyssey House - Loft Transitional Housing 340 E 100 S ................... (801) 322-3222

Odyssey House - Millcreek East 880 E 3375 S ................. (801) 322-3222

Odyssey House - Mothers with Children 42 S 500 E ..................... (801) 322-3222

Odyssey House - Outpatient 350 E 2100 S ................. (801) 322-3222

Odyssey House - Outpatient SLC Day Treatment 350 E 2100 S ................. (801) 322-3222

Odyssey House - Parents with Children Day Treatment 42 S 500 E ..................... (801) 322-3222

Project Reality - Salt Lake City 150 E 700 S ................... (801) 364-8080

Taylorsville Ascendant Comprehensive Treatment

Center 4179 Riverboad Rd Ste 220.......................... (801) 880-0069

West Valley City Hopeful Beginnings ♿

3280 W 3500 S Ste E ..... (801) 979-1351

Ambulatory Surgery Centers American Fork Revere Health - American Fork Surgery

Center 1175 E 50 S Ste 101 ...... (801) 492-5994

Bountiful Lakeview Endoscopy Center

620 E Medical Dr Ste 200.......................... (801) 296-2122

Mountain West Surgical Center 1551 S Renaissance Towne Dr Ste 200.......................... (801) 383-1111


06/12/2020 Page 16


Draper EyeSurg of Utah ♿ ㏄

11820 S State St Ste 150 ......................... (801) 568-0200

Logan South Pointe Surgical Center ♿

810 S 100 N Ste 120 ..... (435) 213-1917

Ogden Mt. Ogden Surgical Center

4364 Washington Blvd ............................ (801) 479-4470

Providence Spring Creek Surgical Center

65 North Gtwy Dr Ste 3 ............................. (435) 535-3257

Salt Lake City Mountain West Endoscopy Center

6360 S 3000 E Ste 320 .. (801) 944-3166 St. Mark's Outpatient Surgery Center

1250 E 3900 S Ste 100 .. (801) 262-0358 Wasatch Endoscopy Center

1220 E 3900 S Ste 1B .... (801) 281-4258

Sandy Lone Peak Surgery Center

10011 Centennial Pkwy Ste 100 ......................... (801) 233-9300

South Ogden Ridgeline Endoscopy Center

6028 S Ridgeline Dr Ste 100 ......................... (801) 475-4900

West Valley City Utah Surgical Center ♿

3715 W 4100 S ............. (801) 957-0200

Cardiac Monitoring Out of State Preventice Services

Houston, TX .................. (888) 500-3522

Diabetes Education Centers Riverton Primary Children's Outpatient

Endocrinology/Diabetes ♿ 3773 W 12600 S ........... (801) 213-3599

Salt Lake City Byram Healthcare Diabetes Specialty

Center 3793 S State St ............. (801) 268-9699

Primary Children's Hospital - Diabetes Clinic ♿ 81 N Mario Capecchi

Dr ............................... (801) 213-3599 Utah Diabetes & Endocrinology Center

615 Arapeen Dr Ste 100 ......................... (801) 581-7761

Diabetes Supply Centers Centerville UUHC Centerville Health Center

Pharmacy 26 S Main St ................. (801) 693-7950

Midvale UUHC Greenwood Health Center

Pharmacy 7495 S State St ............. (801) 213-9540

Orem UUHC Parkway Health Center Pharmacy

145 W 1300 S ............... (801) 234-8510

Park City UUHC Redstone Health Center Pharmacy

1743 W Redstone Ctr Dr Ste 115 ......................... (435) 658-9280

Salt Lake City Byram Healthcare - Murray

645 E 4500 S Ste 200.... (800) 775-4372 Byram Healthcare - Salt Lake City

3793 S State St ............. (801) 268-9699 JQ Medical Supply ♿ ㏄

6910 Highland Dr Ste 4 ............................. (801) 942-8582

University of Utah Hospital Pharmacy 50 N Medical Dr ........... (801) 581-2276

UUHC Redwood Health Center Pharmacy 1525 W 2100 S ............. (801) 213-9950

South Jordan UUHC South Jordan Health Center

Pharmacy 5126 W Daybreak

Pkwy .......................... (801) 213-4550

Stansbury Park UUHC Stansbury Health Center Pharmacy

220 Millpond Rd .......... (435) 843-3050

West Valley City UUHC Westridge Health Center

Pharmacy 3730 W 4700 S ............. (801) 213-9250

Dialysis Centers American Fork UUHC American Fork Dialysis ♿

1159 E 200 N Ste 150 ... (801) 763-0652

Bountiful UUHC Lakeside Dialysis ♿

532 S 500 W.................. (801) 299-3470

Cedar City UUHC Iron Mission Dialysis & Kidney

Clinic ♿ 1277 Northfield Rd ....... (435) 867-8175

Heber City Heber Valley Dialysis Center at IHC ♿

380 E 1500 S Ste 101 .... (435) 654-2500

Hurricane UUHC Hurricane Dialysis & Kidney Clinic

♿ 48 S 2500 W Unit 100 ... (435) 635-0399

Idaho Falls, ID UUHC Gem State Dialysis ♿

2225 Teton Plz Ste A ..... (208) 522-4831

Kanab Kanab Nephrology Clinic ♿

355 N Main ................... (435) 867-8175

Kaysville Anthem Dialysis ♿

520 N Kays Dr Ste 1 ...... (801) 917-9000

Layton UUHC Farmington Bay Dialysis ♿

942 S Main St ................ (801) 593-9111

Mesquite, NV UUHC Desert Valley Dialysis & Kidney

Clinic ♿ 350 Falcon Rdg Pkwy Bldg 700 Ste 104 ........... (702) 345-4144

Ogden UUHC Bonneville Dialysis ♿

5575 S 500 E ................. (801) 479-0351 UUHC Mark Lindsay Dialysis ♿

1151 E Country Hls Dr .. (801) 479-4460

Payson UUHC Payson Dialysis & Kidney Clinic ♿

15 S 1000 E Ste 50 ........ (801) 465-2060

Pleasant View UUHC Pleasant View Dialysis ♿

2715 North Hwy 89 Ste 15............................ (801) 737-9555


06/12/2020 Page 17


Price UUHC Castleview Dialysis & Kidney Clinic

♿ 230 N Hospital Dr Ste 1 ............................. (801) 637-8696

Provo UUHC Provo Dialysis & Kidney Clinic ♿

1675 N Freedom Blvd Ste 15 ........................... (801) 373-0167

Rexburg, ID UUHC Yellowstone Dialysis Center ♿

1165 Summers Dr Ste 15 ........................... (208) 656-0396

Salt Lake City Primary Children's Dialysis Center ♿

81 N Mario Capecchi Dr ............................... (801) 662-1000

UUHC Kolff Dialysis ♿ 423 Wakara Way Ste 200 ......................... (801) 581-3981

Sandy UUHC South Valley Dialysis ♿

8750 S Sandy Pkwy ....... (801) 233-8745

St. George UUHC Dixie Dialysis & Kidney Clinic ♿

720 South Riv Rd Ste D-1100.................... (435) 656-0857

Taylorsville UUHC West Valley Dialysis ♿

3854 W 5400 S ............. (801) 587-8578

Tooele Tooele Valley Dialysis at IHC ♿

196 E 2000 N Ste 112 ... (801) 408-1430

Hearing Centers Blanding Intermountain Hearing Centers -

Blanding ♿ 802 S 200 W ................. (385) 383-7161

Brigham City Intermountain Hearing Centers - Brigham

City ♿ 646 S Main St ............... (435) 239-8860

Layton Intermountain Hearing Centers - Layton

♿ 755 W Antelope Dr ...... (385) 383-7161

Ogden Intermountain Hearing Centers - Ogden ♿

5349 S Adams Ave Ste C ............................. (801) 479-3346

Rock Springs, WY Intermountain Hearing Centers - Rock

Springs 1573 Dewar Dr Ste 2 .... (307) 362-8221

Home Health Agencies Beaver County IHC Homecare Home

Health Cedar City ♿ ....... (435) 868-5852

Box Elder County Community Nursing

Services (CNS) - Brigham Office ............... (435) 723-4404

Community Nursing Services (CNS) - Logan Office ............................. (435) 752-3355

Community Nursing Services (CNS) - Ogden Office ............................. (801) 476-0088

IHC Homecare Home Health Logan ♿ .............. (435) 716-5477

Symbii Home Health and Hospice - Layton ..... (801) 444-0221

Cache County Community Nursing




Rocky Mountain Care - Logan ............................. (435) 753-8220

Symbii Home Health and Hospice - Layton ..... (801) 444-0221

Carbon County Community Nursing

Services (CNS) - Price Office ............................. (435) 613-8887

IHC Homecare Home Health Mt. Pleasant ♿ ... (435) 462-3431

Rocky Mountain Care - Price ............................... (435) 637-8070

Rocky Mountain Care - Price ............................... (435) 637-0665

Daggett County Good Shepherd

Homecare ....................... (435) 789-0499

Davis County A Step Forward -

Clearfield ♿..................... (801) 562-8564 Applegate Homecare &

Hospice - Salt Lake ♿ ...... (801) 261-3023 Community Nursing

Services (CNS) - Layton Office .............................. (801) 774-4960

IHC Homecare Home Health Fillmore ♿ ........... (435) 743-8821

IHC Homecare Home Health Ogden ♿ .............. (801) 399-1400

IHC Homecare Home Health Salt Lake ♿ .......... (385) 887-6000

Inspiration Home Health .. (801) 281-1314 Rocky Mountain Care -

Layton ............................ (801) 397-4900 Salus Homecare -

Midvale .......................... (801) 352-7358 Symbii Home Health

and Hospice - Layton ...... (801) 444-0221

Duchesne County Good Shepherd

Homecare ....................... (435) 789-0499

Emery County Community Nursing

Services (CNS) - Price Office .............................. (435) 613-8887

IHC Homecare Home Health Mt. Pleasant ♿ .... (435) 462-3431

Grand County Community Nursing

Services (CNS) - Moab Office .............................. (435) 259-0466

Iron County IHC Homecare Home

Health Cedar City ♿ ........ (435) 868-5852

Juab County IHC Homecare Home

Health Mt. Pleasant ♿ .... (435) 462-3431

Kane County IHC Homecare Home

Health St. George ♿........ (435) 251-2367

Morgan County Community Nursing

Services (CNS) - Ogden Office .............................. (801) 476-0088


06/12/2020 Page 18


IHC Homecare Home Health Ogden ♿ ............. (801) 399-1400

Symbii Home Health and Hospice - SLC ........... (801) 433-0344

Piute County IHC Homecare Home

Health Richfield ♿ .......... (435) 893-0371

Rich County Community Nursing




Salt Lake County A Step Forward -

Murray ........................... (801) 562-8564 Applegate Homecare &

Hospice - Salt Lake ♿ ...... (801) 261-3023 Community Nursing

Services (CNS) - Infusion Pharmacy ......... (801) 233-6120

Community Nursing Services (CNS) - Salt Lake Corporate Office .... (801) 233-6100

IHC Homecare Home Health Fillmore ♿ ........... (435) 743-8821

IHC Homecare Home Health Salt Lake ♿ .......... (385) 887-6000

Rocky Mountain Care - Salt Lake City .................. (801) 397-4900

Salus Homecare - Midvale .......................... (801) 352-7358

Symbii Home Health and Hospice - SLC ........... (801) 433-0344

San Juan County Community Nursing

Services (CNS) - Moab Office ............................. (435) 259-0466

Rocky Mountain Care - Blanding ......................... (435) 678-3266

Sanpete County IHC Homecare Home

Health Mt. Pleasant ♿ .... (435) 462-3431

Sevier County IHC Homecare Home


Summit County Applegate Homecare &

Hospice - Heber City ♿ ... (801) 654-5983 Applegate Homecare &

Hospice - Park City ♿ ..... (435) 647-3765 IHC Homecare Home

Health Salt Lake ♿ ......... (385) 887-6000 Salus Homecare - Heber .. (435) 657-0574 Symbii Home Health

and Hospice - SLC .......... (801) 433-0344

Sweetwater County, WY Rocky Mountain Care -

Wyoming ....................... (307) 875-7976

Tooele County Community Nursing

Services (CNS) - Tooele Office ............................. (435) 882-3913

IHC Homecare Home Health Salt Lake ♿ ......... (385) 887-6000

Rocky Mountain Care - Tooele ............................ (435) 843-2099

Uintah County Good Shepherd

Homecare ...................... (435) 789-0499

Utah County Applegate Homecare &

Hospice - American Fork ♿ ............................ (801) 763-0101

Community Nursing Services (CNS) - Orem Office ............................. (801) 224-8138

IHC Homecare Home Health Provo ♿ .............. (801) 225-0584

Rocky Mountain Care - Orem ............................. (801) 765-4903

Salus Homecare - Midvale .......................... (801) 352-7358

Star Kids Pediatric Home Health ♿......................... (801) 361-8578

Symbii Home Health and Hospice - Orem ....... (801) 655-4272

Wasatch County Applegate Homecare &

Hospice - Heber City ♿ ... (801) 654-5983 Applegate Homecare &

Hospice - Park City ♿ ..... (435) 647-3765 IHC Homecare Home

Health Heber ♿ .............. (435) 657-4323 Salus Homecare - Heber .. (435) 657-0574 Symbii Home Health

and Hospice - SLC .......... (801) 433-0344

Washington County Applegate HomeCare &

Hospice - St. George ♿ ... (435) 628-1569 Community Nursing

Services (CNS) - St. George Office ................. (435) 652-9077

IHC Homecare Home Health St. George ♿........ (435) 251-2367

Rocky Mountain Care - St. George....................... (435) 673-6699

Wayne County IHC Homecare Home


Weber County Community Nursing


Community Nursing Services (CNS) - Ogden Office .............................. (801) 476-0088

IHC Homecare Home Health Ogden ♿ .............. (801) 399-1400

Rocky Mountain Care - Layton ............................ (801) 397-4900

Symbii Home Health and Hospice - Layton ...... (801) 444-0221

Home Infusion Services Ada County, ID Option Care ...................... (208) 884-2917

Clark County, NV Option Care ...................... (866) 258-3099

Riverside County, CA NuFACTOR ........................ (800) 323-6832

Salt Lake County Community Nursing

Services (CNS) - Infusion Pharmacy.......... (801) 233-6120

IHC Homecare Pharmacy South Jordan ♿ ......................... (385) 887-6000

Option Care - Utah ........... (866) 978-9600 UUHC Specialty and

Home Infusion Pharmacy ....................... (801) 587-6334

Spokane County, WA Option Care ...................... (800) 426-6101

Washington County IHC Homecare

Pharmacy St. George ♿ .. (435) 251-2425


06/12/2020 Page 19


Washoe County, NV Option Care ...................... (800) 829-8416

Home Medical Supplies / Durable Medical Equipment (DME) American Fork Feminine Forms

345 S 500 E ................... (801) 770-0600 IHC Medical Equipment - American Fork

♿ 98 N 1100 E Ste 301B ... (801) 855-3586

Bountiful IHC Medical Equipment - Bountiful Office

♿ 1440 S 500 W ............... (801) 294-0636

Brigham City Advantage Medical Supply

590 Greenwood Dr ....... (888) 270-0202 Community Nursing Services (CNS) -

Brigham Office 345 N Main St Ste B...... (435) 723-4404

Burley, ID IHC Homecare Home Health Cassia ♿

1031 E Main St ............. (208) 678-8844

Cedar City IHC Medical Equipment - Cedar City

Office ♿ 1333 N Main St Ste 102 ......................... (435) 868-5851

Clearfield Eclipse Home Medical ♿ ㏄

570 E 1700 S Ste 204 .... (801) 217-3551

Heber City IHC Medical Equipment - Heber Office ♿

175 N Main St Ste 104 .. (435) 657-4323

Idaho Falls, ID Alpine Home Medical Equipment - Idaho

Falls 2425 Channing Way ..... (208) 535-8627

Kanab Alpine Home Medical Equipment - Kanab

670 South Hwy 89 Ste A ............................. (435) 644-5100

Las Vegas, NV KCI USA

3175 W Ali Baba Ln Ste 806 ............................................. () -

Layton Community Nursing Services (CNS) -

Layton Office 1492 W Antelope Dr Ste 205 ......................... (801) 774-4960

Logan Alpine Home Medical Equipment - Logan

1395 N 400 E Ste A....... (435) 774-4500 IHC Medical Equipment - Logan Office ♿

1300 N 200 E Ste 106 ... (435) 716-5396

Midvale Eye Prosthetics of Utah ♿

7400 Un Park Ave Ste 102 ......................... (801) 942-1600

Fit Well Prosthetics - Midvale 7575 S 900 E ................ (801) 364-3100

National DME ♿ 7757 S Allen St ............. (801) 262-3236

Moab Community Nursing Services (CNS) -

Moab Office 1030 Bowling Aly Ln Ste 1 ............................. (435) 259-0466

Mt. Pleasant IHC Medical Equipment - Mt. Pleasant

Office ♿ 130 W Main St ............. (435) 462-3431

Murray Alpine Home Medical Equipment - Salt

Lake City 4030 S State St ............. (801) 463-0044

IHC Medical Equipment - Intermountain Medical Center ♿ 5171 S Cottonwood St Ste 150 ......................... (801) 507-9100

Ogden Alpine Home Medical Equipment - Ogden

♿ 4669 Harrison Blvd ...... (801) 475-4727

Community Nursing Services (CNS) - Ogden Office 5327 Adams Ave Ste C ............................. (801) 476-0088

Compass Limb and Brace ♿ 1140 36th St Ste 165 .... (801) 392-0075

Debra Lynn's Post-Mastectomy Specialties 1090 E 30th St .............. (801) 393-2885

Fit Well Prosthetics - Ogden 4699 Harrison Blvd Ste 302 ......................... (801) 334-6000

IHC Medical Equipment - Ogden 4421 Harrison Blvd Ste A1 ........................... (801) 387-5450

Orem Community Nursing Services (CNS) -

Orem Office 700 W 800 N Ste 320A ....................... (801) 224-8138

Orthopedic Services of Utah 555 S State St Ste 205 ... (801) 802-8464

TruMobility 1164 W 675 N ............... (801) 607-1050

Price Community Nursing Services (CNS) - Price

Office 480 S Carbon Ave ......... (435) 613-8887

Providence Community Nursing Services (CNS) -

Logan Office 221 North Gtwy Dr Ste G ............................. (435) 752-3355

Provo Alpine Home Medical Equipment - Provo

1481 N State St ............. (801) 852-0077 IHC Medical Equipment - Provo Office ♿

289 W 1230 N ............... (801) 357-8250

Richfield Alpine Home Medical Equipment -

Richfield 43 S Main St .................. (435) 896-6474

IHC Medical Equipment - Richfield Office ♿ 70 E 1000 N Ste B ......... (435) 896-5884

Salt Lake City Byram Healthcare - Murray

645 E 4500 S Ste 200 .... (800) 775-4372 Byram Healthcare - Salt Lake City

3793 S State St .............. (801) 268-9699 Carol's Mastectomy Shoppe ♿

3165 S Main St .............. (801) 483-1262 Fit Prosthetics

154 E Myrtle Ave Ste 100.......................... (801) 912-0500

IHC Medical Equipment - Salt Lake Clinic ♿ 389 S 900 E ................... (385) 282-2200

JQ Medical Supply ♿ ㏄ 6910 Highland Dr Ste 4.............................. (801) 942-8582

KCI USA ♿ 1765 S 900 W................ (800) 275-4524

Loveaire Health Care ♿ 2830 S Redwood Rd ...... (801) 233-6100


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Pediatric Orthotic and Prosthetic Services - West 1275 E Fairfax Rd.......... (801) 536-3827

Sandy Symbius Medical - Utah Branch ♿

427 W Universal Cir ...... (800) 948-1868

South Jordan IHC Medical Equipment - South Jordan

Office ♿ 11520 S Redwood Rd ... (385) 887-7320

St. George Alpine Home Medical Equipment - St.

George 42 South Riv Rd Ste 10 ........................... (435) 674-0080

Community Nursing Services (CNS) - St. George Office 720 South Riv Rd Ste E-101 ...................... (435) 652-9077

Fit Well Prosthetics - St. George 720 South Riv Rd Ste B205 ....................... (435) 634-0070

IHC Medical Equipment - St. George Office ♿ 923 South Riv Rd Ste 104 ......................... (435) 251-2323

Utah Prosthetics and Orthotics 356 E 600 S ................... (435) 688-9338

Tooele Community Nursing Services (CNS

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