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Snow College560 East 200 South, Salt Lake City, UT 84102 8013667555 / 8007657347 Fax: 8013667599 www.pehp.orgEnrollment and Change FormEmployee StatusChanges made on this form are for medical, dental,
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How to fill out pehp - paper claims
How to fill out pehp - paper claims
01
Obtain a paper claim form from PEHP or download it from their website.
02
Fill in the patient's information, including name, address, and PEHP identification number.
03
Provide details of the service or treatment received, including the date, provider name, and diagnosis code.
04
Attach any necessary supporting documentation, such as receipts or medical records.
05
Sign and date the form before submitting it to PEHP for processing.
Who needs pehp - paper claims?
01
Individuals who have received medical services and need to submit a claim to PEHP for reimbursement or coverage.
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What is pehp - paper claims?
PEHP - paper claims refer to the traditional method of submitting health insurance claims on paper forms instead of electronically.
Who is required to file pehp - paper claims?
Healthcare providers or facilities that do not have access to electronic claims submission may be required to file PEHP - paper claims.
How to fill out pehp - paper claims?
PEHP - paper claims can be filled out by obtaining the necessary forms from the insurance provider, completing them with the patient's information, treatment details, and provider's information, and then submitting them via mail or fax.
What is the purpose of pehp - paper claims?
The purpose of PEHP - paper claims is to request reimbursement from the health insurance provider for medical services provided to patients.
What information must be reported on pehp - paper claims?
PEHP - paper claims must include the patient's personal information, treatment provided, dates of service, diagnosis codes, provider information, and charges for services rendered.
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