QUICK REFERENCE GUIDE - UPMC Health Plan

Behavioral Health - UPMC Health Plan

Behavioral Health This section of the UPMC Health Plan Provider Manual contains information pertinent to Behavioral Health Network Providers who …

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Workers’ Compensation Provider Billing Guidelines ...

code meets the requirements. ... Workers’ Compensation Provider Billing Guidelines A. Send an e-mail to the Bureau explaining what you have done to determine

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Welcome and Key Contacts - Quality Health …

Welcome and Key Contacts – Chapter A Welcome and Key Contacts A.2 Welcome A.3 Provider OnLine A.4 UPMC Health Plan Website A.5 How to Use This Manual . A.7 . Key Contacts . A.8 Table A1 -

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Out-of-Network Care Claim Form - UPMC Health …

Out-of-Network Care Claim Form • Both sides of this form must be completed. Incomplete forms will delay payment. • Complete sections 1-5. Have the doctor who treated you complete the

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UPMC Health Plan (Commercial) UPMC HEALTH …

UPMC Health Plan (Commercial) UPMC Health Plan www.upmchealthplan.com © 2014 – 2015 All rights reserved. e 1 UPMC HEALTH PLAN (Commercial) C.2 Employer Group Products at a Glance

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UPMC for Kids - UPMC Health Plan

UPMC for Kids e 1 UPMC for Kids D.2 At a Glance D.4 Covered Benefits D.13 Benefit Exclusions D.14 Member Complaint and Grievance Procedures D.19 Member Rights and …

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G Medical Management5.25.07 - UPMC Health Plan

Medical Management G.2 At a Glance G.2 Procedures Requiring Prior Authorization G.3 How to Contact or Notify Medical Management G.4 When to Notify Medical Management G.7 Case Management Services

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Claims Procedures - UPMC Health Plan

Claims Procedures UPMC Health Plan www.upmchealthplan.com © 2017. All rights reserved. e 6 Paper Claim Forms CMS-1500 forms These forms are for professional services performed in a provider’s office, hospital, or ancillary

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UPMC Community HealthChoices (Medical …

UPMC Community HealthChoices (Medical Assistance) – Chapter N UPMC Community HealthChoices (Medical Assistance) N.2 At a Glance N.3 Medical Assistance Managed Care in Pennsylvania

Change Pay-to Address/Tax ID Change - UPMC …

A group billing address must be the same for every doctor/office under that tax ID. The billing address can only be changed if it is for the whole group with that same tax ID.

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GENERAL ORIENTATION HANDBOOK - UPMC: #1 …

7 Do not leave your area/floor, unless absolutely necessary, and never go to the scene of the fire, unless directed to do so. R.A.C.E.: UPMC Horizon uses the acronym R.A.C.E. to assist employees in remembering the fire policy

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Subject Reason for Review UPMC Health Plan …

MAY 2009 Effective July 1, 2009, UPMC Health Plan will update pricing rules for Relative Value Units (RVU) Multiple Surgery Reduction. These physician multiple-procedure pricing rules will change to mirror the Centers for Medicare & …

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