IMPORTANT UPDATE: Extending the current UPMC Health Plan utilization model for selected MSK, cardiology, and radiology codes

Jan. 2022Important Notices
Prior authorizations for procedures and imaging that were previously managed by HealthHelp (diagnostic imaging, cardiology, and MSK) will be approved until March 1st without review of clinical documentation. However, prior authorization requests must still be submitted for related claims to be paid. Please ensure that requests are submitted with complete information to increase the likelihood that they will meet criteria and be auto approved, eliminating the need for manual review and delayed authorizations.

Recent Announcements

UPMC Dental Advantage celebrates 15-years of growth

From pilot program to now serving all product lines
Jan. 2026What's New

Provider Directory Updates and Required Attestation

As you know, UPMC Health Plan requires all providers to verify their provider directory information at least every 90 days (quarterly).
Jan. 2026Important Notices

Important: Expedited appeals fax requirement

Please remember that you must adhere to the designated process for submitting expedited appeals to have them processed in a timely manner. Follow these guidelines to help you successfully submit expedited appeals:
Jan. 2026Important Notices