Medicare AdvantageAdministrativeMedium impact
Learn more about changes to the Quarterly Provider Attestation process starting in October 2024
UPMC Health Plan·PA·Provider Announcement
Effective date
Oct 1, 2024
We identified it
Aug 7, 2026
Summary
UPMC Health Plan is transitioning its Quarterly Provider Attestation process from an internal system to the Council for Affordable Quality Healthcare (CAQH) platform, effective October 1, 2024. All providers (except Premier Partner offices) must now complete their mandatory 90-day directory verification through the CAQH Provider Data Portal instead of the previous attestation method.
Action Required
By October 1, 2024: Providers and billing staff must transition to CAQH for quarterly attestations. ACTION STEPS: (1) Providers must register with CAQH at the CAQH Provider Data Portal if not already registered; (2) Complete initial provider profile with accurate directory information, supporting documentation, and attestation; (3) Billing/administrative staff should update internal processes to track CAQH attestation deadlines instead of previous system; (4) Designate a point person to receive CAQH verification emails at the beginning of each quarter and respond to follow-up phone calls if necessary; (5) Update provider contact information with UPMC if current email/phone will not receive CAQH communications. NOTE: This does not apply to Premier Partner offices. Failure to complete quarterly attestations through CAQH may result in non-compliance with CMS, DHS, and Pennsylvania Insurance Department requirements and could affect directory accuracy. For assistance, contact your physician account executive or providernetworkinquiries@upmc.edu.