Medicare AdvantageAdministrativeHigh impact
Provider Directory Updates and Required Attestation
UPMC Health Plan·Provider Announcement
We identified it
Aug 28, 2026
Summary
UPMC Health Plan requires all participating providers (except Premier Partners) to verify and attest their provider directory information every 90 days through CAQH ProView portal. This compliance requirement affects network participation and payment eligibility. Providers must ensure phone numbers, addresses, office hours, hospital privileges, telehealth availability, and patient acceptance status are current and accurate, as CMS requires that listed phone numbers must connect to actual appointment availability.
Action Required
ONGOING REQUIREMENT (Quarterly Attestation): Billing and administrative staff must establish a system to ensure provider directory information is verified and attested every 90 days via CAQH ProView portal (https://proview.caqh.org/). SPECIFIC ACTIONS: (1) Front desk/administrative staff: Verify and update the following fields in CAQH and UPMC directory quarterly: ability to accept new patients, street address, phone number, office hours, hospital privileges, telehealth availability, and any other information affecting member access. (2) Providers/Practice managers: Complete attestation in CAQH ProView portal when notified by CAQH alerts, email, or phone outreach. (3) Billing team: Monitor CAQH notifications and set internal calendar reminders for 90-day attestation deadlines. (4) All staff: Cross-verify practice information at upmchealthplan.com/find and update via upmchealthplan.com/providers/change-provider-profile-info.aspx as needed. (5) Providers: Review NPI data in NPPES immediately and maintain current records. CONSEQUENCES: Failure to attest every 90 days may result in removal from provider directory, loss of member referrals, and further action per participating provider agreement, potentially affecting payment eligibility and network participation. CONTACT: Reach out to physician account executive or providernetworkinquiries@upmc.edu for questions or assistance.