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Contracts/Credentialing

Update Demographics (contact information, addresses or email), Report new portal account creation error, or Adding non-contracted provider for claim submission

Please complete the Provider Account Information form and return to PEHP via email: providersubmissions@pehp.org or the Message Center in the New Provider Portal box "Form Submission for Demographic Add, Change, Delete"

Add/Remove a Single Provider from Existing Group Contract (i.e. hospital or clinic)

Please complete the Add/Remove Provider - Current Provider Contract form and return to PEHP via email: providersubmissions@pehp.org or the Message Center in the New Provider Portal. Note: Changes may take up to 60 days to reflect in our Provider Directory. Please check the Provider Directory to verify changes. 

Add/Remove Multiple Providers from Existing Group Contract via Roster Submission

Please complete the roster form and return to PEHP via email: providersubmissions@pehp.org or the Message Center in the New Provider Portal. Note: NPI number required on all changes. Changes may take up to 60 days to reflect in our Provider Directory. Please check the Provider Directory to verify changes.   

New Applications 

PEHP has an open provider panel and welcomes new applications from individual providers and groups. To join a PEHP network, fill out the appropriate form below and send to providersubmissions@pehp.org. 

INDIVIDUAL PROVIDERS

GROUP PROVIDERS

    

PEHP Credentialing Policies  

Providers who contract with PEHP must meet PEHP credentialing requirements. This is true for any individual provider or for group providers who submit a new application and for any provider that is added to an existing group contract. If an individual provider or group fails to keep PEHP informed of any provider’s license restrictions, fails to inform PEHP of any provider actions which may jeopardize the health and safety of PEHP members, or falsely states that the provider is in compliance with PEHP credentialing requirements, the network contract with PEHP shall be immediately terminated, and the provider or group may be subject to applicable civil and criminal penalties.   

Terminate Contract

Please submit a notice of termination at least 30 days prior, as outlined in section 4.3 of the contract.