CommercialAdministrativeMedium impact
Member eligibility and benefits information transitioning from NaviNet to Provider OnLine
UPMC Health Plan·Provider Announcement
Effective date
Mar 20, 2025
We identified it
Jun 20, 2026
Summary
Effective March 20, 2025, UPMC Health Plan network providers will lose access to member eligibility and benefits information through NaviNet and must transition to using Provider OnLine at upmchealthplan.com/providers/medical/. This affects how billing teams verify patient eligibility and benefits for UPMC Health Plan members.
Action Required
Before March 20, 2025: Billing team must transition from NaviNet to Provider OnLine for all UPMC Health Plan member eligibility and benefits verification. Update staff training and workflows to use upmchealthplan.com/providers/medical/ for eligibility checks. Contact Provider Services at 1-866-918-1595 if access issues occur after transition.