UPMC Health Plan achieves high ratings in provider satisfaction

Aug. 2022Important Notices
"In 2021, 95 percent of physician practice survey respondents indicated they would recommend UPMC Health Plan to other physician practices. In addition, respondents ranked UPMC Health Plan in the 93rd percentile or higher on 17 of 19 questions in the 2021 Provider Satisfaction Survey.

UPMC Health Plan contracts with Symphony Performance Health (SPH) Analytics to measure provider satisfaction levels and to meet one or more NCQA Health Plan Accreditation Standards. SPH incorporates a percentile ranking to allow health plans to compare performance to a cohort of similar health plans who initiate a provider satisfaction survey.

You may be a randomly selected provider invited to participate in the 2022 survey that will begin later this month! The survey will ask for feedback on your experience with UPMC Health Plan. Watch for an invitation in the mail or via email later this month."

Recent Announcements

The importance of PRD forms for complex patients and staying updated on changes

Personal representative designation (PRD) forms are critical to the care process for patients and providers alike. Not only do PRDs support accurate, efficient, and compliant patient care—they also streamline administrative processes.
Aug. 2025Important Notices

Important announcement: UPMC Health Plan retires MP.PA.147

This communication is in regards to UPMC Health Plan Policy MP.PA.147 – Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older. UPMC Health Plan previously communicated that the prior authorization requirement under this policy would be paused until Sept. 1, 2025. However, policy MP.PA.147 has been retired, and this policy will no longer be implemented or active.
Aug. 2025Important Notices

CMS expands Medicare Advantage RADV audits to all eligible plans

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a substantial expansion of its Risk Adjustment Data Validation (RADV) audit program for Medicare Advantage plans.
Aug. 2025What's New