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UPMC Health Plan is aware that operations at many of our valued provider partners have been impacted by an incident at Change Healthcare. We are committed to working collaboratively with providers to ensure continuity of business operations.

Please note that UPMC Health Plan is not experiencing any direct outages to core systems or functions at this time. Our prior authorization, eligibility status, claims processing, and claims payment processes are fully operational, and UPMC Health Plan’s provider portal, Provider OnLine, is fully functional and available. Providers can continue to submit claims, check eligibility and benefits, and request prior authorization through Provider OnLine without any disruptions. Additional information is available for reference.

Medical Providers

As the only provider-led health insurer in western Pennsylvania, we recognize the importance of partnership with network physicians and sensitivity to doctor-patient relationships. View resources for medical providers, log into Provider OnLine, and get access to downloadable forms.

Resources for Medical Providers

Dental Providers

Learn about the dental products UPMC Health Plan offers and the variety of resources available to network providers.

Resources for Dental Providers

Vision Providers

UPMC Vision Advantage and UPMC Vision Care* make it easy for you to give your patients high-quality vision care and preventive services. Learn about and take advantage of the resources available to you as a network provider.

Resources for Vision Providers

HCBS Providers

UPMC Community HealthChoices is one of the managed care organizations selected to provide Community HealthChoices (CHC) services in Pennsylvania to those who qualify for Medical Assistance and also qualify for Medicare or require a nursing facility level of care.

Resources for HCBS Providers

NCQA System Control and Information Integrity Requirements

*Administered by National Vision Administrators®