Utah has one of the densest concentrations of treatment programs in the country and a Medicaid system split across plan types and counties. Hartstone & Craft helps Utah detox, residential, PHP, IOP and outpatient programs get paid, whether we run billing for you, build your in-house team or take on one piece like VOBs or authorizations.
In Utah, the payer responsible for a behavioral health claim depends on the member's plan and county. Bill the wrong one and the claim is denied before anyone reads the clinical notes.
Health Choice Utah, Healthy U, Molina Healthcare and SelectHealth Community Care manage physical health benefits for most Utah Medicaid members.
In Davis, Salt Lake, Utah, Washington and Weber counties, Adult Expansion members get physical and behavioral health through one integrated plan.
Elsewhere, county-based PMHPs manage mental health and substance use disorder benefits, so eligibility and authorization rules change at the county line.
Select Health, Regence BlueCross BlueShield of Utah, University of Utah Health Plans, PEHP and national carriers each set their own authorization and level-of-care rules.
Many Utah programs serve clients from other states. We verify out-of-state benefits, negotiate single-case agreements and appeal underpaid claims.
We handle payer enrollment and credentialing for Utah facilities and clinicians so claims do not stall before they start.
We run billing end to end, from VOB and authorizations to payment posting and A/R follow-up, with weekly KPI reporting.
We build and train in-house billing teams, fix workflows, implement billing software and AI integrations, and support audits.
Take on only what you need: VOBs, authorizations, utilization review, claims, A/R follow-up, appeals or credentialing.
Utah licenses behavioral health programs by level of care through the DHHS Office of Licensing. Payers expect the services you bill to match the program you are licensed to run, and your documentation to prove it. We build billing around your license, not the other way around.
Yes. We work with detox, residential, PHP, IOP and outpatient programs statewide, from Salt Lake City and Utah County to St. George, Ogden and Park City. The work happens inside your EHR and clearinghouse, so location is never a barrier.
Yes. We help programs bill Utah Medicaid ACO, integrated care and prepaid mental health plan claims, and sort out which plan is responsible for each member before the claim goes out.
Yes. We help new programs with payer enrollment, credentialing, billing workflows, software setup and hiring or training the billing team before the first admission.
No. Utah is our focus, but we work with behavioral health programs nationwide, in-network and out-of-network.
Every project is scoped and priced individually, from a single service like VOBs to full revenue cycle management. You get a custom proposal after a free discovery call.
Book a free one-hour discovery call with James Gibson. You will leave with a clear read on your billing and your options.
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