Provider OnLine improvements coming in early 2024

Nov. 2023Important Notices
Provider OnLine is a comprehensive resource that allows participating providers to access valuable information online. Starting in early 2024, the site will begin featuring updates to improve your experience. The first of these are updates to member plan (eligibility) information, and improvement to user set up (security management).

Updates to the features include:
  • Improved search speeds.
  • Improved navigation.
  • Expanded participating network information.
  • Policy-level eligibility views.
  • Simplified screen designs.
  • Usability of information presented.

Log in to explore resources
If you have any questions, please contact your physician account executive or call Provider Services at 1-866-918-1595.

Don’t have a Provider OnLine account?
First-time users can create an account by completing an account administrator application.

Recent Announcements

Important announcement – Telehealth submissions

As of October 1, 2025, UPMC Health Plan continues to accept the submission of telehealth claims. Providers may conduct telehealth visits for UPMC Health Plan members in all UPMC Insurance products. UPMC Insurance products include UPMC Advantage group and individual products, UPMC for Life Medicare Advantage plans, UPMC for Kids CHIP plans, UPMC Community HealthChoices, and UPMC for You Medical Assistance plans.
Sep. 2025Important Notices

October 2025 UPMC for You and UPMC Community HealthChoices Formulary Update

Effective October 1st, 2025, Xifaxan and Retin-A (cream, gel) will no longer be covered by UPMC for You and UPMC Community HealthChoices due to non-participation in the Medicaid Drug Rebate Program.
Sep. 2025Pharmacy Updates

Biosimilar Medication Formulary Updates

Updates to formulary biosimilar medications for denosumab, eculizumab, and ustekinumab products
Sep. 2025Pharmacy Updates