Medical Service Providers


Payment Information
  • If the victim has no medical insurance or other collateral source for payment, UOVC shall pay 60% of the billed charges for eligible medical bills
  • If the victim has medical insurance or other collateral source for payment, UOVC shall pay the portion of the eligible medical bills that the victim is obligated to pay according to the insurance agreement
  • Crime-related medications dispensed by a pharmacy shall be paid at the PEHP (Public Employees Health Plan) allowable rates
  • Payment made by UOVC on behalf of a victim, when accepted by the provider, is considered payment in full
Preauthorization for Medical Procedures or Surgery
  • Submit a preauthorization request that includes the procedure coding, costs of the procedure, and treatment notes indicating crime-relatedness
How to Submit Billings for Payment Review
  • Submit either a UB-04 or a CMS-1500 billing form, along with the insurance Explanation of Benefits, if applicable
  • If there may be a question of crime relatedness, please include the medical records
  • If the provider has never been paid by the state of Utah, please submit a W-9 form
How to Submit Documents

FAX:  (801)533-4127

Email:  crimevictims@utah.gov

Mail:    Utah Office for Victims of Crime
             350 E. 500 S. Suite 200
             Salt Lake City, UT 84111

For additional questions

Contact the UOVC Provider Liaison

Amy Armstrong
(801)238-2377
aarmstrong@utah.gov