Provider News & Info

July 2023

We would like to remind that PEHP will not be issuing new ID cards to additional members until July 2024, which is the date of our next scheduled migration to the new claims payment system. This extension will allow us to focus on resolving any outstanding issues before adding new members to the new system. Currently, only 15% of our total membership has been migrated during phases 1 and 2.

Member ID Lookup Tool: Your source for accurate information

To ensure accurate and timely claim processing during our system transition, please use the correct ID number as shown on the PEHP ID card. To verify your patient’s current PEHP ID number, you can use the Member ID Lookup Tool available when you log in to the Classic Account. See how.

Remember:

• If the ID number begins with 174100, submit claims using the Classic Account.
• If the ID number begins with M0000, submit claims using the New Account.
• When submitting claims through UHIN or a clearinghouse, ensure you have the correct member ID number for processing.
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By following these guidelines and utilizing the Member ID Lookup Tool, you'll help prevent payment delays and facilitate a smooth transition.

How to view PEHP clinical policies & authorization forms

We want to make you aware of a new benefit available to certain PEHP members: Childbirth Doula Services. Under Utah HB 415, birth doula services will be a covered health plan benefit for eligible PEHP members from July 1, 2023, through June 30, 2026.

This new benefit is only available to pregnant PEHP members who work for the State of Utah and certain other employers.

Covered services include prenatal and post-partum support from in-network doulas. Labor support is only covered when the birth occurs at an in-network birthing center or in-network hospital. Note: This benefit is in addition to our pregnancy and postpartum WeeCare program.



Please share this exclusive benefit with your pregnant patients who work for the State of Utah.