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Electronic Claims Submission Tool

PEHP now offers an online tool which allows providers to create a primary or COB claim directly from pehp.org via the secure provider portal.

The “Submit Medical Claims” link is located on the left hand side of the home screen in the provider portal.

To create a COB claim, simply enter the amounts and adjustment codes which are located on the primary payer’s remittance advice. The remittance information may be on paper, an EDI 835, or primary payer’s website. You may be required to enter a RARC and CARC code. Visit http://www.wpc-edi.com/reference/ to learn more about these codes.

The PEHP online claims tool only allows claims to be submitted individually and does not provide batch claim functionality. All batch claims must still be submitted through UHIN. This tool is a great option however; EDI claim submission through your practice management software, clearinghouse or UHIN is preferred.