How does UPMC Health Plan select providers and hospitals?

When we select providers to participate in network plans, we at UPMC Insurance Services Division must follow certain policies to measure the ratio of providers to members. This ensures there is an adequate number of providers to meet our members' health care needs. Providers include primary care providers (PCPs), specialty providers, behavioral health providers, dentists, vision care providers, and hospitals.

We build our network of providers by reviewing internal demographic data about our members. Quality, member experience, patient safety, and cost-related measures are not used when selecting network providers. However, all our providers and facilities are credentialed according to the standards of UPMC Insurance Services Division, the National Committee for Quality Assurance, and all other applicable statutory and regulatory bodies.

Nominate a provider

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

If you prefer to print the form, you can access the PDF here.

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Requester Information

Your information will be kept strictly confidential. It will be used only by 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

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For more information, call our Health Care Concierge team at 1-888-876-2756 (TTY: 711).