Dear Provider,

Transitioning to a new claims payment system is a complex endeavor that inevitably presents challenges and disruptions. We are sincerely grateful for your cooperation and understanding during this transition.

Here’s an update on our transition timeline and the issues we’re addressing:

• Next phase postponed to July 2024. This extension will allow us to focus on resolving any outstanding issues before adding new members to the new system. While we have made significant progress over the last 6 months, there is still more to be resolved before we migrate more members to the new system. Currently, only 15% of our total membership has been migrated during phases 1 and 2. See new schedule.

• PEHP will suspend the issuance of new ID cards until July 2024. To verify your patient’s current PEHP ID number, please use the Member ID Lookup Tool using the Classic Portal.

• Claim payment delays. We acknowledge that there have been delays in claim payments, and we appreciate your patience. One of the contributing factors to these delays is a mismatch between the data submitted on the claim and the data submitted to PEHP. Instead of denying the claim or requesting additional data, we are actively researching and rectifying these mismatches. We are pleased to report that we cleared more than 5,000 claims from our workbasket last week. Thank you for your understanding as we address these issues.

• Missing remittance advice/EOP. The best way to view a remittance advice/EOP for a claim submitted in the new system is to log in to the New Portal and choose Office Management--> Communications Archive from menu on top. Make sure to select the provider entry with the Supplier number “S000xxx” (not the Supplier Location or Practitioner number). If you don’t see a remittance advice/EOP for a past claim, please send us a message via the Message Center in the New Portal.

• Missing 835. If you’re missing 835 files for a past payment, please call our EDI department at 801-366-7544 or email edi.helpdesk@pehp.org.  

How to Contact Us

Instead of a single person, you now have a dedicated team of provider specialists available to assist you. If you need to report a new issue or have any concerns, the best way to reach us is by calling our Member and Provider Service Center at 801-366-7555 or sending us a message via the Message Center in the New Portal.

We apologize for any inconvenience you may be experiencing during this transition. Once fully implemented, the new claims payment system will enhance our ability to serve you and our members across all PEHP departments.

Thank you for your continued partnership in serving our members. We appreciate the opportunity to work with you.

For the latest information, please visit www.pehp.org/providers.