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| General Information |
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| Personal Health Concerns |
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| Claim Questions? |
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: 801-366-7555 |
| : 800-765-7347 |
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How
do I contact Provider Relations? |
- By mail:
Provider Relations
Public Employees Health Program
560 E 200 S
Salt Lake City, Utah 84102
- By fax: 801-366-7773
- By phone: 800-677-0457
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How do I become a medical provider for PEHP? |
PEHP is currently
accepting applications from medical providers for our Preferred Medical
Panels in the following specialties and/or areas: psychiatry, endocrinology,
rheumatology, surgical centers, or providers in counties outside the
Wasatch Front. If you meet the above criteria, please contact the Provider Relations Representative
for your area including your name, tax identification number, specialty,
location, and phone number.
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How do I become a dental provider for PEHP? |
PEHP is
currently accepting applications from dental providers for our Preferred
Dental Panel in the following specialties and/or areas: endodontics,
periodontics, prosthodontics, pedodontics, providers in counties outside
the Wasatch Front or dental providers interested in participating with
the Children’s Health Insurance Program (CHIP) Dental Plan only.
If you meet the above criteria, please contact the
Provider Relations Representative
for your area including your name, tax identification
number, specialty, location, and phone number.
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How
long does the credentialing process take? |
The credentialing
process can take up to 4 weeks to complete. Completion of an application
does not guarantee membership on the PEHP Panels regardless
of your specialty or location. If you have questions regarding credentialing,
please contact the Provider Relations Representative
for your area.
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How do I change my billing or physical address? |
Send us an update
including your name, old address, phone number and tax identification
number, new address, phone number and tax identification number, the
effective date of the change, and the address for claims with dates
of service prior to the effective date of the change. The information
can be mailed or faxed to the
Provider Relations Representative
for your area.
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How
do I add multiple locations? |
Send us an update
including provider name, billing address and phone number, physical
address and phone number, effective date of new location, and tax
identification number. The information can be mailed or faxed to the
Provider Relations Representative for your area.
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How
long will it take for my claims to be paid? |
PEHP processes
clean claims within 45 days.
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Who
do I contact if my claims are paid incorrectly? |
For claims questions,
please contact PEHP Customer Service at 801-366-7555 or 800-765-7347.
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How do I obtain fee schedule information? |
To obtain fee
schedule information, fax a request on letterhead. Please include
provider name, location, tax identification number, patient (if applicable)
and specific codes. The request can be mailed or faxed to the
Provider Relations Representative
for your area.
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How do I get on the Exclusive Care, or Summit Care
provider panels? |
CHIP Exclusive Care utilizes a provider panel that is leased from IHC.
Please contact IHC directly for information on joining these panels
at 801-442-5014. Summit Care is a provider panel leased from Wise Provider Networks.
Please contact Wise directly for information on joining the Summit
Care panel at 801-566-6655.
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How do I submit claims electronically? |
Currently PEHP
receives all EDI claims through the Utah Health Information Network
(UHIN). Contact UHIN at 801-466-7705 or PEHP’s EDI Help Desk
at 801-366-7544.
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What can I do online? |
Providers
can log onto myPEHP
provider to check member eligibility, benefit limits, and claim
status. Providers can also access provider lists online or link to
the Medco website to look at PEHP’s
formulary . For details read a Provider Manual.
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Can I balance bill the member if they don’t pay their copayment
in a timely manner? |
Contracted providers
can only bill members for service charges and interest related to
the collection of the copayment.
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