All PlansAdministrativeMedium impact
Self-servicing update
UPMC Health Plan·Provider Announcement
Effective date
Apr 15, 2024
We identified it
Aug 7, 2026
Summary
Effective Monday, April 15, 2024, UPMC Health Plan is requiring all participating providers to use self-service options (online portal at upmchealthplan.com/providers or IVR system) for routine inquiries including claim status, member eligibility, benefit information, authorization creation/verification, and EOP access. Phone-based support for these functions will no longer be available through traditional channels.
Action Required
By April 15, 2024: Billing team must transition all routine provider service requests (claim status inquiries, eligibility verifications, benefit information lookups, authorization creation/verification, and EOP access) from phone-based support to UPMC's self-service portal (upmchealthplan.com/providers) or Interactive Voice Response (IVR) system at 1-800-937-0438. Train all billing staff on portal navigation and IVR procedures. Update internal workflows and provider communication templates to direct staff to use self-service options first. For questions about portal functionality, contact Provider Services Web Support Team at 1-800-937-0438. Failure to transition processes may result in delays in obtaining necessary claim and eligibility information.