UPMC Health Plan:Provider Pharmacy Resources

If you require a prior authorization for a medication not listed here, please contact UPMC Health Plan Pharmacy Services at 1-800-396-4139. UPMC Health Plan makes all decisions on prior authorization requests within 24 hours from the time of initial review.

Our Prior Authorization process has been enhanced to better serve you. To see several common questions and answers that arise around the Prior Authorization process, click on the icon to the right.

Prior Authorization Process:
UPMC Health Plan makes all decisions on prior authorization requests within 24 hours from the time of initial review. The Health Plan occasionally requires additional information when completing a clinical review. If additional information is required, we will fax a letter to your office that details what additional information is needed.

The requested information must be received within 24 hours of the original prior authorization request, or the request will be denied due to lack of sufficient information for review. The Health Plan will notify you of its prior authorization decision via fax on the date the actual decision is made. If your office is unable to receive faxes, you will be notified via U.S. mail.

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