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Case Management

Our Case Managers assist members with acute conditions by helping them to find economical ways to meet their healthcare needs without compromising quality of care. Provider referrals are welcome.                          		 801-366-7755
or
800-753-7490

Disease Management

Our Case Managers assist members with chronic conditions by helping them to maintain a relatively healthy state through patient education, early intervention, continuity of care and outcome research. Provider referrals are welcome. 		801-366-7755
or
800-753-7490

Customer Service & Outpatient Pre-Authorization

Our Customer Service Representatives answer questions relating to claims, member eligibility, and benefits (limitations and exclusions). They initiate outpatient and pharmacy pre-authorizations and addresses general Master Policy questions.                           

801-366-7555
or
800-765-7347

EDI Helpdesk

Our EDI helpdesk answers detailed EDI questions including testing and rejection code issues. They set up providers for EDI and adds them to existing trading partner numbers. Provides payer ID’s and addresses EDI claim payments to wrong payees.                           

801-366-7544
or
800-753-7818

Provider Relations

Our Provider Relations Specialists act as a liaison between providers and PEHP. 		801-366-7557
or
800-677-0457

Inpatient Pre-notification

All inpatient medical services requires pre-notification

801-366-7555
or
800-765-7347

Inpatient Mental Health/Substance Abuse Pre-Authorization.
All inpatient mental health/substance abuse requires pre-authorization
Blomquist Hale Consulting Group (BHCG)
Canyons School District
Jordan School District
Nebo School District		 801-262-9619
or
800-926-9619
Mental HealthCare of Utah (MHCU)
All other employer groups		 801-293-7400
or
800-541-9432

WeeCare

WeeCare is a prenatal program that offers support and services that promote a healthy, safe, and enjoyable pregnancy. Provider referrals are welcome. 		801-538-9943
or
800-662-9660

Wellness Works

The PEHP Wellness Works program is an interactive website that assists members with diet, nutrition, and fitness support and offers an array of customizable wellness tools. 		801-366-7478
or
800-753-7478

PEHP Waist Aweigh Obesity Intervention Program

The PEHP Waist Aweigh obesity intervention program focuses on members with a BMI of 30 or higher. It provides support, education and financial incentives. This program is successful with the involvement of the member’s primary care physician. 		801-366-7478
or
800-753-7478
Beginning July 1, 2010

PEHP will no longer be administering any CHIP medical or dental plans.

PEHP will continue to pay CHIP claims with dates of service prior to July 1, 2010.

Start preparing now....

Start preparing now for the electronic healthcare transactions change to Version 5010 and the ICD-10 conversion. Speak with your practice management vendor or clearinghouse about these coming changes.

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