PROVIDERS
The Region's Only Provider-Led Plan
Many features on our website require Adobe Reader.
Download Adobe Reader for free.
As the only provider-led health insurer in Western Pennsylvania, we recognize the importance of partnership with network physicians and sensitivity to doctor-patient relationships.
Announcements
| 8/2010 | Product Recall Coumadin® 1 mg blister packs (Bristol-Myers Squibb) more ... |
| 5/2010 | Referral of UPMC for Kids (CHIP) Members to Medical Assistance All health plans that offer CHIP will identify current CHIP members with “serious health conditions” who may qualify for the Medical Assistance special health care needs program. more ... |
| 4/2010 | Improvements to Provider OnLine! A new Web-based application, online chat, and a new Security Officer position will improve security and efficiency. more ... |
| 3/2010 | UPMC for You (Medical Assistance) Benefit Changes: Effective April 1, 2010 Details on the changes |
| 3/2010 | Product Recall — OneTouch SureStep Test Strips (LifeScan) Attention: Diabetes health care professionals, consumers more ... |
| 12/2009 | 2010 CPT Code Changes Beginning January 1, 2010, the Centers for Medicare & Medicaid Services (CMS) will be eliminating the use of Evaluation and Management (E&M) Consultation CPT Codes (99241-99255) for its Medicare providers and requiring them to bill the most appropriate office visit or hospital inpatient CPT Codes (99201-99215, 99221-99239). more ... |
| 9/2009 | Provider OnLine Reactivation Request If you have not accessed your Provider OnLine account in the past six months your account may be disabled. Request that your account be reactivated |
| 3/2009 | Medical Assistance Provider Self-Audit Tool The Department of Public Welfare (DPW) has recently developed a formal protocol for disclosing overpayments or improper payments of Medical Assistance (MA) funds. More on DPW website... |
 |
Recent issues |
View Past issues >> |
Medical Assessment Form PA 635
DPW is working with the Managed Care and Behavioral Health Managed Care Organizations to let you know that a revised Medical Assessment Form PA 635 will soon be in use. DPW is planning to implement a Work Ready Screening Tool and Medical Assessment and Treatment Plan pilot in Allegheny County. More...
Medicare Non-Coverage Appeal Rights
These forms are for Skilled Nursing Facilities, Comprehensive Outpatient Rehabilitation Facilities, and Home Health Providers. UPMC for Life participating providers may now use the UPMC Health Plan-specific Notice of Medicare Non-Coverage (NOMNC) forms required by CMS.
Important Message from Medicare
On November 27, 2006, the Centers for Medicare & Medicaid Services (CMS) published a final rule, CMS-4105-F: Notification of Hospital Discharge Appeal Rights. Beginning July 2, 2007, hospitals must deliver a revised version of the Important Message from Medicare to inform Medicare beneficiaries who are hospital inpatients about their hospital discharge appeal rights. This notice is required for every Medicare beneficiary. Beneficiaries who choose to appeal a discharge decision will receive a more detailed notice. The most current versions of these forms are available on the CMS website.
Please continue to visit the CMS website for more information on the above forms, and to print the most current versions of these forms, at http://www.cms.hhs.gov/BNI/12_HospitalDischargeAppealNotices.asp.
Managed Care Organizations' Providers are Required to Register their NPI Numbers with DPW
Managed Care Organizations’ providers are required to register their National Provider Identifier (NPI) numbers with the Department of Public Welfare (DPW). The link below provides instructions for registering NPI numbers with DPW. More...