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Pre-authorization

Some drugs require pre-authorization because of potential for misuse, adverse reactions, safety issues, and cost.

Providers must obtain a pre-authorization by calling 801-366-7555 or 800-765-7347. Forms are available at myPEHP for Providers.

We'll let your office know if the pre-authorization request has been approved or denied. You may also call 801-366-7555 or 800-765-7347 for the status of the request.

*The pre-authorization list may be subject to change. Call PEHP at 801-366-7705 or 800-765-7347 for information on any medication.

 Drug NameAdministratorPhysician pre-authorization phone numberMember inquiry phone number
1. AbraxanePEHP Pharmacy(801) 366-7555(800) 765-7347
2. AciphexPEHP Pharmacy(801) 366-7555(800) 765-7347
3. ActemraPEHP Pharmacy(801) 366-7555(800) 765-7347
4. ActimmunePEHP Pharmacy(801) 366-7555(800) 765-7347
5. ActiqPEHP Pharmacy(801) 366-7555(800) 765-7347
6. AdagenPEHP Pharmacy(801) 366-7555(800) 765-7347
7. AdcircaPEHP Pharmacy(801) 366-7555(800) 765-7347
8. Adderall (After age 18)PEHP Pharmacy(801) 366-7555(800) 765-7347
9. Adderall XR (After age 18)PEHP Pharmacy(801) 366-7555(800) 765-7347
10. AdvatePEHP Case Management(801) 366-7555(800) 765-7347
11. AfinitorPEHP Pharmacy(801) 366-7555(800) 765-7347
12. AldurazymePEHP Pharmacy(801) 366-7555(800) 765-7347
13. Alferon-NMedco(800) 753-2851(800) 903-4725
14. AlimtaPEHP Pharmacy(801) 366-7555(800) 765-7347
15. AllegraPEHP Pharmacy(801) 366-7555(800) 765-7347
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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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