Care Coordination & Member Support

At PEHP, we understand that navigating the healthcare system can sometimes feel overwhelming. Our dedicated Care Coordination team is committed to making your healthcare journey as smooth as possible. Whether you have questions about your medical claims, need clarification about your benefits, need help with pharmacy services, or need help obtaining preauthorizations for treatments or procedures, we’re here to support you every step of the way.

Who Can Request Care Coordination?

Members
Healthcare Providers
Family Members or Authorized Representatives

Our team will work closely with you, your providers, and your support network to ensure that your healthcare experience is well-coordinated and focused on your best outcomes.

How We Can Support You

Appeal Inquiries: Whether you need to submit an appeal or check its status, we’re here to support you throughout the process.
Care Coordination: Work with a registered nurse or health coach who collaborates with you and your healthcare providers to develop and manage a care plan that ensures you receive timely, appropriate care.
Claims or Explanation of Benefits (EOB) Inquiries: Receive assistance in understanding your claim status or resolving any issues related to your Explanation of Benefits.
Healthcare Benefits: Have questions about your medical coverage? We’re available to explain your benefits and help you understand your options.
Pharmacy Benefits: Our team can provide guidance and assistance.
Preauthorization: If a procedure or service requires prior approval, we can help you with the necessary forms.
Provider Search: Let us help you find the right doctor or specialist nearby in your network.

How to Reach Us

Care Coordination Request: Complete the Care Coordination Request form and submit it through the PEHP Message Center or fax it to 801-366-7449.
Phone: 801-366-7555
Message Center: Send us a message via the secure Message Center in your PEHP account.

Care Coordination Request Form