PEHP Medicare Supplement claims processing
Some of our members are enrolled in both Medicare and a PEHP Medicare supplement plan to help cover services Medicare doesn't cover. The biggest challenge with our new system is the integration with Medicare for accurate claims processing and payment, mostly centered around data synchronization between PEHP, the Federal Medicare Program, and providers.
While we've made significant progress in correcting and processing Medicare supplement claims, glitches remain. To facilitate a streamlined claims process, kindly consider the following:
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Member ID and Location Match: When submitting a claim form to Medicare for a patient with a PEHP Medicare Supplement plan, please ensure that the member ID number and your facility/practitioner location correspond accurately with our records at PEHP.
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Update Information with Medicare: If updates are needed for your location information with Medicare, we recommend contacting them directly to ensure alignment.
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Update Information with PEHP: For any updates to your location information within PEHP's system, please complete and submit this form electronically to providersubmissions@pehp.org
Making sure your provider information and patient information match with Medicare and PEHP is critical for a seamless claim process.
Thank you for your attention in this important matter.
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