Other Helpful Information
Know Before You Go
As healthcare gets costlier and more complex, carefully consider where and how you get care to maximize your PEHP benefits. Know Before You Go means taking a few simple … more
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Know Before You Go
As healthcare gets costlier and more complex, carefully consider where and how you get care to maximize your PEHP benefits. Know Before You Go means taking a few simple … more
Coordination of benefits (COB) claims are those claims your primary insurance has already paid and PEHP becomes your secondary insurance. Cash-paid (direct) claims are those you paid the cash price … more
ATTENTION
PEHP is replacing its claims payment system in phases based on when a member's plan year begins. On July 1, 2025, a large part of our membership was moved to the new system. The rest … more
Pharmacy Forms
Coordination of Benefits/Direct Claim Form (pdf)Submit Claim Form ElectronicallyExpress Scripts Home Delivery Order Form (pdf)
How does my Pharmacy/Medical Identification Card … more
Affected Providers
Hospitals
Other providers billing for services under the Inpatient Prospective Payment System (IPPS) and/or Outpatient Prospective Payment System (OPPS).
Professional claims … more
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PEHP plans are self-funded. Here's what that means to you
Self-funding is a proven, cost-effective method for providing employee benefits.
With a self-funded medical plan, an employer puts … more
A contracted provider has the responsibility to file the claim within 12 months from the date of service. Claims denied for untimely filing are not the member’s responsibility, unless one of the … more
PEHP offers affordable Life and Accident insurance plans you can count on.
Get the coverage you need to ensure your loved-ones will be financially secure in the event of your death or … more
2025 Medical Fee Schedule Notice
This is a contractual notice that PEHP will be updating the medical reimbursement fee schedule effective July 1, 2025.
The updated medical fee schedule reflects … more
A contracted provider has the responsibility to file the claim within 12 months from the date of service. Claims denied for untimely filing are not the member’s responsibility, unless one of the … more