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Patients

Before Your Visit

Pre-Registration

Our hospital offers online Pre-Registration for your upcoming, scheduled visit. Please submit your information at least two business days before your arrival. If you are experiencing a life threatening emergency, go directly to the ER or dial 9-1-1. This form is NOT intended for Emergency Room use.

Pre-Registration Secure Form

Health Plans

Salt Lake Regional Medical Center currently accepts the following health plans. If your managed healthcare plan is not listed, please contact customer service at 801-350-8559 regarding coverage. Some affiliates may not be listed.

AETNA-ALTIUS NETWORK

AETNA-PEAK PREFERENCE NETWORK

ALTIUS – (Excludes Mountain Star)

ALTIUS HEALTH PLANS*

AMERICA’S HEALTH PLAN

ARCHES HEALTH PLAN

AUTO LIV**

BCE EMERGIS

BEHAVIORAL MEDICINE

  • CIGNA Behavioral Health
  • Davis Behavioral Health
  • Life Synch
  • MHNet
  • Optum Behavioral Health
  • United Behavioral Health

REGENCE Blue Cross/Blue Shield

  • BlueCard (National)
  • BlueOption***
  • Regence (Traditional Plans)
  • ValueCare
  • Federal Employee Program (FEP)

CHAMPUS

CHOICE CARE

CIGNA HEALTHCARE OF UTAH

CLEARFILED JOB CORP (MTC)

CONCENTRA PREFERRED SYSTEMS

COVENTRY***

DMBA***

EMPLOYER DIRECT HEALTHCARE

FIRST HEALTH

GEHA

GREAT-WEST HEALTHCARE

HEALTH CHOICE PREFERRED

HEALTH CHOICE UTAH

HEALTH MANAGEMENT NETWORK (HMN)

HEALTH UTAH / TALL TREE ADMINSTRATORS

HEALTHY U

HOSPICE

  • CareSource Hospice
  • Inspiration Hospice
  • Odyssey Healthcare
  • Vista Hospice

HUMANA

HUMANA HMOX*

INTEGRATED HEALTH PLAN

J-U-B ENGINEERING**

MAILHANDLERS***

MANAGED CARE ADMINISTRATORS

UTAH MEDICAID – (Except Community Care)

MEDICARE

MEDICARE ADVANTAGE PLANS

  • Altius
  • CorpHealth
  • Deseret Secure
  • HumanaChoice PPO
  • Humana Gold Choice
  • Molina Healthcare Options
  • MED-CARE Advantage
  • Optum
  • Regence BCBSU
  • UniCare
  • UnitedHealthcare

MERITAIN HEALTHCARE

MOLINA

MOLINA MARKETPLACE*

MULTIPLAN

NPPN (PlanCare America; Plan Vista)

PEHP

  • Murray City – Preferred Care
  • Outside Agencies – Preferred Care
  • Salt Lake County – Preferred Care
  • University of Utah – Preferred Care
  • Utah School Boards Association –
  • Gold and Silver Care

PEHP CAPITAL

PEHP SUMMIT CARE

PEHP SUMMIT EXCLUSIVE

PHCS (Private Health Care Systems)

PLANCARE AMERICA: (See NPPN)

PRIME HEALTH SERVICES

QUESTAR**

THREE RIVERS NETWORK

TRI-CARE / UNITED MILITARY SERVICES

UNITEDHEALTHCARE OPTIONS PPO

UNIVERSITY OF UTAH HEALTH CARE

USA MANAGED CARE

WISE PROVIDER NETWORK

WORKERS COMP FUND OF UTAH

WORKERS COMPENSATION – All Plans

*Healthcare Marketplace (Exchange) Plans

**Employer Direct Contracts

***Some plans may be out of network please contact Financial Counseling

ALL INSURANCES ACCEPTED THROUGH EMERGENCY DEPARTMENT

PRIVATE PAY – Patients are eligible for substantial discounts when payment is made at time of service.

If the managed healthcare plan in question is not listed above, please contact the Hospital’s Insurance Verification Office regarding policy coverage (801) 350-4122. Some affiliates may not be listed.

Medical Records

Salt Lake Regional Medical Center maintains medical records for each patient treated at the hospital. To request your medical records, please visit our Health Information Management department between the hours of 8:00 a.m. – 4:30 p.m., Monday through Friday, or call 801-350-4882. Prior to receiving copies of records or authorizing records to be disclosed, you will be asked to complete the appropriate form and provide proof of your identification with a valid, government issued photo ID.

The appropriate form, along with a copy of your proof of identification, may be faxed to 801-350-4390. Requests for medical records generally take up to 72 hours to process.

The following form should be used for requests to inspect or obtain a copy of one’s own records or those of a patient for whom you are the legal representative.

Request a Copy of PHI (English)

Request a Copy of PHI (Español)

The following form should be used for requests to disclose medical records to a third party.

Authorization to Release Records (English)

Authorization to Release Records (Español)

Records needed for continuing care purposes do not require the completion of any of the above referenced forms, but rather will be sent directly to your provider.

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1050 East South Temple – Salt Lake City, UT 84102
(801) 350-4111

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