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Provider Directory Updates and Required Attestation
UPMC Health Plan·Provider Announcement
We identified it
Aug 7, 2026
Summary
UPMC Health Plan requires all providers (except Premier Partners) to verify and attest their provider directory information every 90 days through CAQH to comply with CMS/DHS/PID requirements and the No Surprises Act. Providers must ensure accurate contact information, office hours, hospital privileges, and telehealth availability in the directory. Failure to attest quarterly may result in contractual action and payment suspension.
Action Required
IMMEDIATE ACTION REQUIRED: (1) Billing/administrative staff must verify practice information is current in UPMC Health Plan directory at upmchealthplan.com/find and submit updates at upmchealthplan.com/providers/change-provider-profile-info.aspx. (2) Ensure all providers and office staff are registered with CAQH Provider Data Portal at https://proview.caqh.org/ and complete attestation when CAQH sends notifications (quarterly requirement). (3) Verify and update the following information in both CAQH and UPMC directory: ability to accept new patients, street address, phone number, office hours, hospital privileges, telehealth availability, and any changes affecting member access. (4) Review NPI data in NPPES (National Plan & Provider Enumeration System) to ensure accuracy. (5) Mark calendar for 90-day attestation deadlines to prevent payment suspension. Contact providernetworkinquiries@upmc.edu or physician account executive with questions. CONSEQUENCE: Failure to attest every 90 days may result in removal from directory, inability for members to find practice, and further contractual action per participating provider agreement.