Medical Preauthorization

Preauthorization

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.

» Genetic testing

» Home Health Out of State or Out of Network

» Hearing Aids (Select Groups only; check your plan documents)

This list shows some common services that require preauthorization.

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

Non-authorized services are considered Provider Responsibility.