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  • Remittance Advice

    A remittance advice/EOP details how your claim was processed. PEHP offers three convenient ways to obtain it:

    Electronic (835)

    Sent electronically after claim adjudication.

    Benefits: … more

  • Electronic Claims Submission Tool

    PEHP now offers an online tool which allows providers to create a primary or COB claim directly from pehp.org via the secure provider portal.

    The “Submit Medical Claims” link is located on the left … more

  • Health Insurance Basics

    HEALTH INSURANCE BASICS

    Plan vs Network

    Your plan outlines your medical coverage, and your network determines which doctors, clinics, and hospitals you visit for in-network healthcare. Make … more

  • EDI Transactions

    PEHP currently supports the following transactions:

    837: Health Care Claim – PEHP accepts dental, professional and institutional claims. PEHP will return a Functional Acknowledgment (999) report … more

  • Medical Preauthorization Forms

    If you're a contracted provider, please log in to your PEHP Provider Account to view and download authorization forms. Send all forms and applicaple patient notes to document clinical information. … more

  • Primary Care Provider – Your Partner in Healthcare

    A primary care doctor can help with short-term problems and take care of you over time, making them a crucial partner for your health. Here are five reasons why having a primary care doctor matters: … more

  • Credentialing Policy

    Upon receipt of a completed application, the application is reviewed and if the applicant has met the credentialing requirements a contract will be sent. The credentialing process may take up to … more

  • Medicare Documents and Resources

    FREE MEDICARE PRESENTATIONS » Join us for a free presentation to learn about Medicare and PEHP’s Medicare Supplement plans. We’ll be available after each presentation to answer questions.

    » … more

  • PEHP WeeCare

    PEHP WeeCare is our prenatal and postpartum program. WeeCare is designed to help expectant mothers have a safe pregnancy and deliver a healthy baby. All PEHP members are eligible to participate.* … more

  • ROI Dental Calculator

    How Much Can Your Office Save by Billing Electronically?

    The dental return on investment (ROI) calculator tool helps offices identify the cost-savings potential that can be achieved by switching … more