PEHP requires all contracted providers to submit their claims electronically. PEHP currently sends and receives healthcare transactions through the Utah Health Information Network (UHIN) or through a number of clearinghouses and billing services that submit through UHIN.
Providers who wish to send and receive electronic healthcare transactions themselves and not through a clearinghouse will need to contact UHIN at 801-466-7705 to establish a trading partner number (TPN). The TPN will be used for all payers that accept claims through UHIN. Once the TPN has been established, please contact the EDI Department at PEHP, 801-366-7544 or 800-753-7818, to be set up in our system and arrange testing.
When a new provider is added to your practice, please contact the EDI Department to add the new provider to the correct TPN to avoid claim rejections. We will need to know the trading partner number as well as the individual NPI number, and tax identification number (TIN).
After the set up and testing is complete, providers can then send their claims electronically to PEHP.
Providers who have not established access to electronic submission may key in claim information and submit their claims through the PEHP website at no charge. If your office does not have login credentials, please contact PEHP at 801-366-7555 or 800-765-7347. Providers can submit both primary and COB claims with this tool.
If you're an Out-of-Network (OON) provider serving PEHP members and need to be added to our system to submit claims via our website or your preferred clearinghouse, please fill out the Provider Account Information Form. See the types of claims PEHP will accept by paper.
The video below only explains how to submit claims using the Classic Portal. To submit claims via the New Portal, please read the Provider User Guide.