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.
If you're in doubt, get the procedure code from your doctor and look it up at the Quality & Code Lookup at PEHP for Members or call us to verify. The PEHP Master Policy has complete details about preauthorization. Find it in your benefits information library at PEHP for Members.
Also, the following inpatient services require preauthorization by calling PEHP at 801-366-7755 or 800-753-7754:
» Inpatient hospital medical admissions at Primary Children’s Medical Center.
» All inpatient hospital rehabilitation admissions.
» Skilled nursing facilities.
» All inpatient mental health and substance abuse admissions.
» All inpatient out-of-network, rehabilitation, skilled nursing, mental, and substance abuse admissions.
» Long-term acute care (LTAC) stays.