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  • Other Helpful Information

    Know Before You Go

    As healthcare gets costlier and more complex, carefully consider where and how you get care to maximize your PEHP benefits. Know Before You Go means taking a few simple … more

  • Coordination of Benefits

    Coordination of benefits (COB) claims are those claims your primary insurance has already paid and PEHP becomes your secondary insurance. Cash-paid (direct) claims are those you paid the cash price … more

  • Forms & FAQs

    Pharmacy Forms

    Coordination of Benefits/Direct Claim Form (pdf)Submit Claim Form ElectronicallyExpress Scripts Home Delivery Order Form (pdf)

    How does my Pharmacy/Medical Identification Card … more

  • Communications

    PEHP is updating its claims payment system in phases. Learn more

    National Drug Code Billing Requirement

    Affected Providers

    Hospitals

    Other providers billing for services under the Inpatient … more

  • National Drug Code Billing Requirement

    Affected Providers

    Hospitals

    Other providers billing for services under the Inpatient Prospective Payment System (IPPS) and/or Outpatient Prospective Payment System (OPPS).

    Professional claims … more

  • Why Self-Funding Matters

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    PEHP plans are self-funded. Here's what that means to you

    Self-funding is a proven, cost-effective method for providing employee benefits.

    With a self-funded medical plan, an employer puts … more

  • Timely Filing

    A contracted provider has the responsibility to file the claim within 12 months from the date of service. Claims denied for untimely filing are not the member’s responsibility, unless one of the … more

  • Are You Covered in Case of Death or Disability?

    PEHP offers affordable Life and Accident insurance plans you can count on.

    Get the coverage you need to ensure your loved-ones will be financially secure in the event of your death or … more

  • Timely Filing

    A contracted provider has the responsibility to file the claim within 12 months from the date of service. Claims denied for untimely filing are not the member’s responsibility, unless one of the … more

  • Code Edits

    Clear Claim Connection is a web-based tool by McKesson Health Solutions that lets providers review PEHP’s claim auditing rules and the clinical rationale behind them. It offers easy access to claims … more