Provider Nomination

You can use this form to nominate a provider to join the UPMC Health Plan network.

*Indicates required field

Requester Information

Your information will be kept strictly confidential and will be used only by the UPMC Health Plan to contact you for more information about the providers you are nominating.

We do our best to offer members a robust network. However, not all providers will be offered the opportunity to participate. Doctors must have admitting privileges to a participating hospital to be considered.

Provider Information

Submit Request

For more information, call UPMC Health Care Concierge team 1-888-876-2756. Toll-free TTY 711.