PRISM
PRISM Training
Learn MorePRISM FAQs & Guides
Learn MoreContact PRISM
Learn MorePRISM Portal Access
Learn MoreProvider Training Calendar
Learn MoreStarting May 1, 2023, DHHS will begin issuing a new Medicaid card to replace the old Utah Department of Health (UDOH) card for newly enrolled Medicaid members. Each new Medicaid member will get their own card. Existing members will continue to use their old UDOH Medicaid card. Please accept both DHHS and UDOH Medicaid cards. Learn more in the New Medicaid Card FAQ for Providers opens in a new tab
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.PRISM system downtime notifications are made in recorded messages on the customer service hotline, as well as with banner messages here on the Medicaid website, in the PRISM system, and in the UHIN system. To be notified of PRISM system downtimes by email, subscribe below.
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PRISM Project Go-Live
Background
In April 2023, Utah Medicaid replaced the Utah Medicaid Management Information System (MMIS) with a new system called Provider Reimbursement Information System for Medicaid (PRISM). The Provider Enrollment component of PRISM was implemented in 2016 and updated in June 2020. After a soft go-live in January 2023, PRISM is now fully operational with the following components:
Managed Care Processes
Prior Authorization
Member Eligibility
Claims Adjudication
Claims Payments
Member Web Portal
Audit Studio (Fraud and Abuse System)
Claims Submission
With the new PRISM system, paper claims are no longer accepted. Any paper claims that are received will be securely destroyed and no longer returned to providers or their vendors.
There may be a learning curve to submitting claims for payment. To help provider offices with these changes, virtual calls have been scheduled so that providers can efficiently ask questions and get answers. Get the Provider Billing and Claims Q&A schedule.
Provider Trainings
To help providers with the system changes, new eLearning courses are available.
Helpful Resources
Detailed information about PRISM functionality, including claims submissions, can be found below:
PRISM FAQs and Guides
Medicaid Information Bulletin (MIB) articles are published throughout the year with information on how PRISM will impact providers. View or subscribe to MIB articles to stay up-to-date with PRISM.
Utah Medicaid Official Publications
Multi-Factor Authentication
Providers will need to go through a multi-factor authentication process to access the PRISM application. Please visit the links below for additional information:
March 2021 Interim MIB opens in a new tab
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Multi-Factor Authentication Registration Instructions opens in a new tab
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