ACA Risk Adjustment Claims Submission Announcement
Feb. 2025Important Notices
Notice: Submit your claims for ACA members
UPMC Health Plan would like to remind all network providers to submit all outstanding CY 2024 claims for ACA members (Platinum, Gold, Silver, and Bronze plans), no later than April 1, 2025. The U.S. Department of Health & Human Services requires all issuers to submit their calendar year claims to the EDGE server by April 30 every year in order to provide more complete and an accurate picture of each patient’s health status. Any claims adjudicated after the deadline are not included for EDGE data submission.
You can submit claims through Provider OnLine at upmchealthplan.com/providers/medical. If you have any questions, please reach out to Provider Services or your physician account executive.
Recent Announcements
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).Apr. 2026Important Notices
Voluntary nationwide recall: Alcohol Pads (Cardinal – March)
Cardinal Health is recalling multiple lots of Webcol™ Large Alcohol Prep Pads (70% isopropyl alcohol). Alcohol prep pads are used for external cleansing of the skin.Mar. 2026Pharmacy Updates
Medical device correction: Omnipod 5 (Insulet – March 2026)
Insulet Corporation has announced a medical device correction for certain Omnipod 5 pods. These pods are wearable devices that are used to deliver insulin.Mar. 2026Pharmacy Updates
