PEHP only accepts paper claims for the following:
- Tertiary (2 separate EOBs attached)
- Include Medical Records attached
- Air ambulance claims with records
- Invoices for vaccine clinics (CNS, Costco, etc. for employers)
Please submit all claims to:
PEHP Claims Department
560 E 200 S
Salt Lake City, Utah 84102-2004
Claims must be sent on appropriate claim forms: UB-04 or CMS-1500. Handwritten claims will not be accepted.
Required Information for Claims Submission
Codes (include all applicable):
- CPT (Current Procedural Terminology)
- HCPCS (Health Care Financing Administration’s Common Procedural Coding System)
- ICD-10 (International Classification of Diseases)
- NDC # (National Drug Code)
- Rendering provider name
- Rendering provider NPI #
- Billing provider tax ID #
- Provider’s charge(s) for the service(s) rendered
Processing / Turn Around Time
PEHP generally processes claims within 45 days. Please note, the turnaround time for paper claims is longer than electronically submitted claims due to the extra handling required.
- Claims are paid by PEHP directly to Contracted Providers
- Claims are paid by PEHP directly to the member in the name of the provider unless otherwise required by the No Surprises Act.