MAINTENANCE ALERT: Scheduled maintenance is planned for Tuesday, 1/22/2019 beginning at 9:00 PM until approximately 9:30 PM. During this time, website functionality and secure logins may be affected by intermittent partial or complete outages. We apologize for any inconvenience and thank you for your patience as we work to upgrade our system.

Policies & Procedures Manual

* Medical policies require prior authorization from our Medical Management department. Submit prior authorizations via Provider OnLine. If you have any questions, contact Medical Management at 1-800-425-7800.

♦ Disclaimer: Policies and procedures designated with a ♦ are pending approval by the Department of Human Services (DHS) and are not currently approved for use for the Medical Assistance product. Please refer to the UPMC Health Plan website frequently for updates on approval.

A

Medical Policies - Prior Authorization*

Pay Policies

Back to Top ↑

B

Medical Policies - Prior Authorization*

Pay Policies

Back to Top ↑

D

Medical Policies - Prior Authorization*

Back to Top ↑

E

Medical Policies - Prior Authorization*

Pay Policies

Back to Top ↑

F

Pay Policies

Back to Top ↑

H

Medical Policies - Prior Authorization*

Pay Policies

Pharmacy Policies - Prior Authorization

Back to Top ↑

I

Medical Policies - Prior Authorization*

Pay Policies

Back to Top ↑

K

Medical Policies - Prior Authorization*

Back to Top ↑

L

Medical Policies - Prior Authorization*

Pay Policies

Back to Top ↑

M

Pay Policies

Back to Top ↑

N

Medical Policies - Prior Authorization*

Pay Policies

Clinical Resource Management

Back to Top ↑

O

Medical Policies - Prior Authorization*

Pay Policies

Back to Top ↑

P

Medical Policies - Prior Authorization*

Pay Policies

Back to Top ↑

R

Pay Policies

Back to Top ↑

S

Medical Policies - Prior Authorization*

Pay Policies

Back to Top ↑

T

Medical Policies - Prior Authorization*

Pay Policies

Clinical Resource Management

Back to Top ↑

U

Pay Policies

Back to Top ↑

V

Medical Policies

Pay Policies

Back to Top ↑

W

Medical Policies - Prior Authorization*

Back to Top ↑
Apple Store Google Play