Important: Expedited appeals fax requirement

Jan. 2026Important Notices

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:

  • Submit by fax only: You must submit all expedited appeal requests by fax to 412-454-7920.
  • Avoid email/mail: Submitting expedited appeals by email or mail will cause processing delays and may prevent completion within the required 48-hour time frame.
  • Remember all required documentation: All expedited provider appeals must include the Expedited Medical Necessity Appeal Request Form available on the UPMC Health Plan website.

Failure to follow this process may result in processing delays. For more information on the process, view the Provider Manual – Chapter B, Provider Disputes.

Recent Announcements

Community Care Behavioral Health is excited to announce this free upcoming web-based training opportunity:

A growing body of U.S. and international research demonstrates that the rapid legalization and commercialization of gambling—including online casinos and mobile sports betting platforms—are associated with significant and escalating gambling related harm. Although Pennsylvania specific prevalence data remain limited, available evidence is increasingly concerning, with gambling disorder linked to alarmingly high rates of suicide, psychiatric comorbidity, and social and financial harm. Drawing on lessons from the tobacco and opioid crises, this presentation will examine how delayed recognition and regulation can amplify population level harm, underscoring the need for earlier screening, prevention, and policy engagement. Participants will gain practical guidance on identifying patients at elevated risk, implementing evidence informed screening and diagnostic strategies, and applying current treatment approaches across the lifespan.
May 2026Education/Webinars

Bridging Smiles and Systems: Collaborative Care for Children with Chronic Conditions

Please join us for a live, CME-accredited and CEU-accredited webinar on May 13 from noon to 1p.m., that will explore the critical connection between oral health and pediatric chronic conditions such as diabetes, asthma, congenital heart disease, and ADHD.
Apr. 2026Education/Webinars

Certified Community Health Worker (CCHW) Provider Billing Notification

UPMC for You will now reimburse for up to three certified community health worker (CCHW) visits per member per calendar year for Medicaid recipients, per the Pennsylvania Department of Human Services (PA DHS).
Apr. 2026Important Notices