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Policies & Procedures Manual

*Medical policies require prior authorization from our Medical Management Department. Submit prior authorizations via Provider OnLine. To review the HealthHelp clinical guidelines and prior authorization codes for cardiology, advanced radiology/imaging, sleep, and musculoskeletal, visit the medical prior authorizations page.

If you have any questions, contact Medical Management at 1-800-425-7800.

To view the redlined versions of the policies, visit upmchp.us/ProviderRLDocs.

♦ 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.