Notice: Submit your claims for ACA members
Apr. 2024Important Notices
UPMC Health Plan would like to remind all network providers to submit all outstanding calendar year 2023 claims for ACA members no later than April 15, 2024. HHS requires all issuers to submit their calendar year claims to the EDGE server by April 30 every year in order to provide a more complete and accurate picture of each patient’s health status. Any claims adjudicated after the deadline are not included for EDGE data submission.
Claims can be submitted via the secure portal.
If you have any questions, please contact Provider Services or your physician account executive.
Claims can be submitted via the secure portal.
If you have any questions, please contact Provider Services or your physician account executive.
Recent Announcements
Voluntary nationwide recall: Ocaliva (Intercept – September)
Intercept Pharmaceuticals, Inc. is voluntarily withdrawing Ocaliva® (obeticholic acid) from the market. Ocaliva is used to treat a rare liver disease called primary biliary cholangitis (PBC).Oct. 2025Pharmacy Updates
HelpScript service helps patients enroll in manufacturer copay assistance programs
End-to-end provider support helps ensure a smooth submission processOct. 2025Important Notices
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