PEHP for Providers

The PEHP for PROVIDERS is a secured online provider site allowing you to easily and cost-effectively access resources and information that can simplify and expedite your organization’s daily tasks. As a partner in the delivery of optimal healthcare services to our members and your patients, we are continually striving to assist you in the efficient administration of your organization.

Our secure website allows you to:

• Access member eligibility and effective dates.
• Check status of submitted claims and payment information.
• Download pharmacy preauthorization forms.
• Download medical preauthorization forms.
• Obtain benefit limits information.
• Obtain contracted fees via Fee Schedule Lookup.
• Obtain deductibles.
• Review PEHP’s claim auditing rules and clinical rationale via Clear Claim Connection.
• Verify and request address changes for both physical and billing addresses.
• Verify current tax identification number (TIN).
• Verify National Provider Identification Number (NPI).
• View and print claims remittance.
• Submit Medical Claims
• Review PEHP’s Clinical Policies
• Access appeal forms
• Set up Electronic Funds Transfer (EFT) services
• Review registered account users
• Access member satisfaction reviews from our directory
• Review EDI claims acknowledgements
• Enter a URL to display on your provider directory profile