Complete reinstated PROMISe ID enrollment requirements to avoid claim denials for Medical Assistance, CHC, and CHIP
Jul. 2023Important Notices
All service locations must comply with the reinstated PROMISe™ ID enrollment requirements to avoid claim denials for patients with UPMC for You (Medical Assistance), UPMC for Kids (Children’s Health Insurance Program/CHIP), and UPMC Community HealthChoices coverage for service dates starting Sept. 1, 2023. Providers who offer, order, refer, or prescribe services for patients with these coverage types must take the following steps to comply with the requirements:
- Enroll every service location where they see members with the Department of Human Services (DHS).
- Obtain a PROMISe ID (also known as a Medicaid ID or MPI) and revalidate these locations as required every five years.
- Log in to PROMISe to check the revalidation dates of each service location and submit revalidation applications at least 60 days prior to the revalidation dates.
- Enroll any service locations that are not listed in PROMISe.
Review Medical Assistance Bulletin 99-21-01 and Medical Assistance Bulletin 99-22-11 to learn more about the reinstatement of provider enrollment requirements.
Contact DHS with questions on provider enrollment, revalidation, enrollment fees, site visits, and criminal background checks. You can reach DHS at 1-800-537-8862 (option 2, option 4, option 2).
Recent Announcements
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.Feb. 2026Education/Webinars
February 2026 UPMC for You and UPMC Community HealthChoices formulary update
Pulmicort Flexhaler has a new distributor, Rubicon Holding. National Drug Codes (NDCs) for Pulmicort Flexhaler from Rubicon Holding are not included in the Medicaid Drug Rebate program and are not covered under the Medicaid Prescription Drug Program. Pulmicort Flexhaler NDCs from the previous manufacturer, H2 Pharma, have been discontinued but may be billed/dispensed until supplies are exhausted.Feb. 2026Pharmacy Updates
CME Webinar: American Foundation for Suicide Prevention’s ‘Talk Saves Lives’ Program
Please join us on Tuesday, April 28, from noon to 1 p.m. for “Talk Saves Lives: An Introduction to Suicide Prevention.” This live, CME-accredited webinar is the American Foundation for Suicide Prevention’s flagship suicide prevention education program. It covers the scope of this leading cause of death, warning signs and risk factors for suicide, and strategies to prevent it.Feb. 2026Education/Webinars