Orchard - Unchanged


Update Demographics (contact information, addresses or email)

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.   

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

Please complete the Add/Remove Provider - Current Group 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 PortalNote: 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.   

Terminate Contract

To terminate a contract, please submit a written notice of termination by certified mail at least 30 days prior, as outlined in section 4.3 of the contract. 

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




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.