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Provider Information

• Behavioral Health Confidentiality
• Behavioral Health Patient Safety Guidelines
• Clinical Guidelines
• Complaints and Grievances Process
  • UPMC Health Plan (commercial patients)
  • UPMC for You (Medicaid patients)
  • UPMC for Life (Medicare patients)
• Domestic Violence
• Electronic Data Interface (EDI)
• Health Management Programs
• HIPAA (Health Insurance Portability and Accountability Act) Privacy Guidelines
• Medical Necessity Statement Describing How Health Plan Decisions Are Made
• Medical Record Documentation Guidelines
• Member Access to Network Providers
• Member Rights and Responsibilities
• Pharmacy formularies and tables
  • UPMC Health Plan (commercial patients)
    • First Choice Benefit Guide
    • Your Choice Benefit Guide
    • Value Choice Benefit Guide
  • UPMC for You (Medical Assistance patients)
    • Your Prescription Drug Program (2006)
• Physician-Patient Communication Guidelines
• Preventive Health Guidelines
  • Children (posted 05/11/07)
  • Adult (posted 05/11/07)
• Provider Accessibility Standards
• Provider Resource Guide (2006)
• Provider Satisfaction Results
• Quality Improvement Program Information
• Quality and Safety
• Utilization Management Criteria
• Women’s Health and Cancer Rights Act

Provider Services
UPMC Health Plan
One Chatham Center
112 Washington Place
Pittsburgh, PA 15219-9533

< For Providers