CommercialAdministrativeHigh 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
Aug 7, 2026
Summary
Effective March 20, 2025, UPMC Health Plan network providers must transition from using NaviNet to access member eligibility and benefits information to using the new Provider OnLine portal at upmchealthplan.com/providers/medical/. NaviNet access will no longer be available after this date. Billing teams must update their workflows to use the new portal and ensure all staff are trained on the transition.
Action Required
By March 20, 2025: Billing team, front desk staff, and all clinical personnel must transition from NaviNet to Provider OnLine for accessing member eligibility and benefits information. (1) Update all internal procedures and workflows to direct staff to upmchealthplan.com/providers/medical/ instead of NaviNet. (2) Train all staff who currently use NaviNet on how to access and navigate Provider OnLine. (3) Update any automated system integrations or scripts that may reference NaviNet. (4) Remove NaviNet bookmarks and system access where applicable. (5) Document the new portal access process in billing procedures. Contact UPMC Provider Services at 1-866-918-1595 or your physician account executive with any access issues. Failure to transition by the effective date will result in inability to verify eligibility and benefits, potentially delaying claim submission and causing billing delays.