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providers The Region's Only Provider-Led Plan

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.

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4/2014 Pharmacy Recall Notice
Product recall: Effexor XR or generic venlafaxine ER capsules (more...)
3/2014 Capture the details.
When it comes to managing your patients’ health, there’s no such thing as too much information.


It’s important to paint a detailed picture of each patient after every encounter. Be sure to include any chronic conditions. Complete, accurate coding improves the quality and coordination of your patients’ care.

Need to boost your coding expertise? We offer resources to help you and your staff prepare for ICD-10. View a schedule of free classes.

To register, email riskadjustment@upmc.edu. You can also call 412-454-7266 or 412-454-5904.

1/2014 Pharmacy Recall Notice
Product recall: Sodium Chloride 0.9% Injection Solution (more...)
1/2014 Pharmacy Recall Notice
Product recall: Gardasil (more...)
12/2013 Education Opportunities for 2014
Interested in free coding and documentation education? Click here to learn more.
12/2013 Prior Authorizations through Provider OnLine
Do you have questions? Click here for answers to frequently asked questions.
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Recent issues

April 2014

March 2014

February 2014

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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...)