UPMC Health Plan achieves high ratings in provider satisfaction

Jul. 2024Important Notices

In 2023, 96 percent of physician practice survey respondents indicated they would recommend UPMC Health Plan to other physician practices. In addition, respondents ranked UPMC Health Plan in the 95th percentile when comparing UPMC Health Plan to other Health Plans with whom they participate.

UPMC Health Plan contracts with Press Ganey, to measure provider satisfaction levels and to meet one or more NCQA Health Plan Accreditation Standards. Press Ganey incorporates a percentile ranking to allow health plans to compare performance to a cohort of similar health plans who initiate a provider satisfaction survey.

You may be invited to participate in the 2024 survey that will begin next month. The survey is provided to a random sampling of primary care network providers and will ask for feedback on your experience with UPMC Health Plan. Watch for an invitation in the mail or via email next month!

Recent Announcements

Clinical documentation required for hip, knee, and shoulder prior authorizations

As you know, UPMC Health Plan requires certain clinical documentation/notes in support of a request for prior authorization for hip, knee, and shoulder procedures in accordance with its established policies and procedures, in addition to CMS requirements that medical record documentation must support the medical necessity of the services requested.
Jul. 2025Important Notices

Clinical documentation required for hip, knee, and shoulder prior authorizations

As you know, UPMC Health Plan requires certain clinical documentation/notes in support of a request for prior authorization for hip, knee, and shoulder procedures in accordance with its established policies and procedures, in addition to CMS requirements that medical record documentation must support the medical necessity of the services requested.
Jul. 2025Important Notices

Understanding MP.PA.147

Understanding changes to the Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 policy
Jul. 2025Important Notices