PEHP
PEHP is a payer organization operating in Utah. For an ASC, what matters isn't the logo. It's how PEHP pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete PEHP analysis
Tell us where to send it. Our team will prepare an analysis of PEHP covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How PEHP pays
See how PEHP reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
PEHP's presence spans Utah. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for PEHP and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive PEHP's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking PEHP up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with PEHP
- Payer ID
- 10574 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to PEHP through a clearinghouse.
- Eligibility verification
- Coverage and benefits for PEHP members are verified before the date of service, through a clearinghouse using payer ID 10574or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with PEHP directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of PEHP the way it pays.
- What is PEHP's payer ID?
- PEHP's electronic payer ID is 10574. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to PEHP through a clearinghouse.
- How do ASCs verify eligibility for PEHP members?
- Eligibility and benefits for PEHP members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 10574) or through the payer's provider portal.
- Does PEHP require prior authorization for ASC procedures?
- Prior-authorization requirements for PEHP are set per plan and per procedure. Confirm whether an authorization is required with PEHP directly before the date of service.
- What type of payer is PEHP?
- PEHP is a payer organization operating in Utah.
- How does PEHP compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where PEHP pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is PEHP paying my ASC below market?
- Put your own PEHP contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.