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Preauthorization

Some services require preauthorization. To get preauthorization, 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 PDF file shows some common services that require preauthorization. Genetic testing is commonly overlooked.

The PEHP Master Policy has complete details about preauthorization. Find it in your benefits information library when you log in to your PEHP account.

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.

This list PDF file shows medical codes with applicable policies that require preauthorization.

See medical preauthorizaiton forms

See pharmacy preauthorization forms