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Medical Management

For questions about referrals and prior authorization requests, utilization reviews, disease management programs, and other health services, contact:

PHP Medical Management
260-432-6690, ext. 12

/resources/frequently-asked-questions

How do I get more information?

PHP's goal is to provide quality products and superior service. Questions about benefits, eligibility, claims payment, prior authorization, or the participation status of doctors, hospitals, or other facilities can be addressed by our Customer Service Department.

PHP Customer Service Department

260-432-6690, Extension 11
1-800-982-6257, Extension 11
260-459-2600 for the hearing impaired
custsvc@phpni.com

/resources/frequently-asked-questions

Who to Contact

Find out who to contact for questions about participating with us, updating participation status or practice information, fee schedules, staff in-services, billing, contracting efforts, and more!

/providers/php-at-a-glance/who-to-contact

Off-Plan referrals

A referral to a non-participating specialty doctor may be obtained if a uniquely specialized procedure is medically necessary and not performed by any participating doctors.  This process must be requested by the participating doctor and approved by PHP, in writing, prior to receiving the services.  It is the member's responsibility to notify us of the initial appointment date, or a change to the date they were given by the physician.

If the visit results in a recommendation for further treatment such as therapy, durable medical equipment, additional testing or surgery, the member must notify us prior to receiving these services.  The non-participating specialty doctor you were referred to should send claims associated with the visit to:

PHP
PO Box 2359
Fort Wayne, IN 46801-2359

After the visit, the non-participating specialty doctor should send the treatment plan summary to PHP's vendor partner:

Valenz Health

FAX:  (863) 333-4417

Download a list of services requiring prior authorization.

/resources/frequently-asked-questions

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