Some services require preauthorization. To get it, your doctor must call PEHP (801-366-7555). Most doctors know how and when to do this, but it’s your responsibility to verify. Otherwise, your benefits could be reduced or denied. This list shows some common services that require preauthorization. Genetic testing is commonly overlooked. If you’re in doubt, get the procedure codes from your doctor and call PEHP. The PEHP Master Policy has complete details about preauthorization. Find it in your benefits library.
Also, all inpatient hospital admissions and all inpatient rehabilitation admissions require pre-notification. Similar to preauthorization, this requires a call or fax from your doctor to PEHP.