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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

Jordan Valley Medical Center currently accepts the following health plans. If your managed healthcare plan is not listed, please contact 1-888-333-4812 regarding coverage. Some affiliates may not be listed.

AETNA PLANS Aetna Select
• Elect Choice EPO
• Managed Choice POS
• Open Choice PPO
• Aetna Choice POS & POS II
• Aetna HealthFund
• Aetna Open Access
• (Excludes Utah Connected Network Plan)
AETNA-ALTIUS NETWORK
AETNA-PEAK PREFERENCE NETWORK
AMERICA’S HEALTH PLAN
AUTOLIV Employees
BCE EMERGIS
BEHAVIORAL MEDICINE
• CIGNA Behavioral Health
• Davis Behavioral Health
• Life Synch-Humana Behavioral Health
• MHNet
• Optum Behavioral Health
• United Behavioral Health
REGENCE BLUECROSS & BLUESHIELD
• Regence ValueCare
• Regence Participating (Traditional)
• Federal Employee Program (FEP)
• All BCBS National Plans (BlueCard)
• (Excludes FocalPoint)
CHAMPUS
CHOICE CARE
CIGNA HEALTHCARE OF UTAH
CLEARFIELD JOB CORP (MTC)
COVENTRY
DMBA
FIRST HEALTH
GEHA
GREAT WEST HEALTHCARE
HEALTH CHOICE PREFERRED
HEALTH CHOICE UTAH
HEALTHNET FEDERAL SERVICES
HEALTH UTAH
HEALTHYU
HSA HEALTH PLANS
HUMANA
HOSPICE
• CareSource Hospice
• Inspiration Hospice
• Odyssey Healthcare
• Vista Hospice
INTEGRATED HEALTH PLAN
J-U-B ENGINEERING Employees
MAILHANDLERS
MEDICAID
MEDICAID ACCOUNTABLE CARE PLANS
• Health Choice Utah
• HealthyU
• Molina
• ( Excludes Community Care)
MEDICARE
MEDICARE ADVANTAGE PLANS
• AARP Medicare Complete
• AETNA
• BlueCross
• Healthy Advantage & Advantage Plus
• Humana Choice HMO & PPO
• Humana Gold Choice
• Molina Options & Options Plus
• MED-CARE Advantage
• Optum
• UnitedHealthcare
MERITAIN HEALTHCARE
MOLINA
MOLINA MARKETPLACE*
MULTIPLAN
PEHP
PEHP CAPITAL
PEHP SUMMIT CARE
PEHP SUMMIT EXCLUSIVE
PHCS (Private Health Care Systems)
THREE RIVERS NETWORK
TRICARE
TRIWEST
UNITED MILITARY SERVICES
UNITEDHEALTHCARE OPTIONS PPO
WISE PROVIDER NETWORK
WORKERS COMP FUND OF UTAH
WORKERS COMPENSATION – All Plans

ALL INSURANCES ACCEPTED THROUGH THE EMERGENCY DEPARTMENT

FEDERAL MARKETPLACE PLANS –
MOLINA Marketplace

Medical Records

Jordan Valley Medical Center – West Valley Campus, 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 8:30 a.m. – 4:30 p.m., Monday through Friday, or call 801-964-3272.

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 801-964-3467.

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 & 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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3460 South 4155 West
West Valley City, Utah 84120

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