Contracts/Credentialing

New Applications

PEHP is currently accepting applications from medical providers along the Wasatch front from the following specialties only: psychiatry, endocrinology and rheumatology. Outside the Wasatch front, other specialties may be needed and medical providers in these areas are welcome to apply. Regardless of the location, providers joining a practice currently contracted with PEHP or taking over the practice of a provider currently contracted with PEHP may apply.

Providers who meet the above criteria and PEHP credentialing requirements can begin the application/credentialing process. Download the correct application below:

INDIVIDUAL PROVIDERS

• Individual Medical Provider Application and Agreement (pdf)
• Individual Dental Provider Application and Agreement (pdf)
• Individual Autism Services Provider Application and Agreement (pdf)

GROUP PROVIDERS

• Group Medical Provider Application and Agreement (pdf)
• Group Dental Provider Application and Agreement (pdf)

If approved, a contract will be sent to the credentialed provider. The effective date of network participation is based upon when PEHP receives the signed agreement. PEHP will make the effective date the 1st of the month if received by 15th of the month, otherwise it will be the first of the following month.

Credentialing/Re-Credentialing

Delegated Credentialing

PEHP may delegate credentialing activities to contracted provider groups that include at least three providers. The group must agree to follow PEHP credentialling requirements.

Recredentialing

PEHP requires that all providers falling within the scope of the PEHP program complete the recredentialing process at least once every three years. All providers are expected to respond to a recredentialing request in a timely manner, including providing proof of insurance and associated limits. All providers must be recredentialed and approved for continued network participation.