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Provider News & Info


July 2023

Reminder: PEHP has suspend the issuance of new ID cards until July 2024

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.


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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.
  • 

By following these guidelines and utilizing the Member ID Lookup Tool, you'll help prevent payment delays and facilitate a smooth transition.

See how to use Member ID Lookup Tool 

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.

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Important update on hospital acquisition


As you may already know, Centura Health recently acquired the hospitals formerly owned by Steward Health Care. Please know that this change does NOT impact PEHP members. If you have patients in the PEHP Summit Network, you can assure them that the following hospitals are still in-network:

  • Davis Hospital and Medical Center in Layton is now Holy Cross Hospital — Davis
  • Jordan Valley Medical Center is now Holy Cross Hospital — Jordan Valley
  • Jordan Valley Medical Center-West Valley Campus is now Holy Cross Hospital — Jordan Valley West
  • Mountain Point Medical Center in Lehi is now Holy Cross Hospital — Mountain Point
  • Salt Lake Regional Medical Center is now Holy Cross Hospital — Salt Lake
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