Search results with tag "Upmc health plan"
Claims Procedures - UPMC Health Plan
www.upmchealthplan.comUPMC Health Plan (Commercial), UPMC for Kids (CHIP), UPMC Medicare Special Needs Plan (SNP), and UPMC for Life (Medicare) members. UPMC Health Plan accepts claims up to 180 days after the date of service for UPMC Community HealthChoices and UPMC for You (Medical Assistance) members.
Welcome and Key Contacts - UPMC Health Plan
www.upmchealthplan.comWelcome 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 - UPMC Health Plan (Commercial) A.10 Table A2 - UPMC for Kids (CHIP) A.12 Table A3 - UPMC for You (Medical Assistance) A.22 Table A4 - UPMC for Life (Medicare)
Landscape - UPMC Health Plan
www.upmchealthplan.comthe Landscape of Health Care UPMC HEALTH PLAN 2006 ANNUAL REPORT One Chatham Center 112 Washington Place Pittsburgh, PA 15219 www.upmchealthplan.com
Behavioral Health - UPMC Health Plan
www.upmchealthplan.comBehavioral Health This section of the UPMC Health Plan Provider Manual contains information pertinent to Behavioral Health Network Providers who are providing services to:
I Mem Admin5.25.07 - UPMC Health Plan
www.upmchealthplan.comMember Administration UPMC Health Plan www.upmchealthplan.com © 12/1/17. All rights reserved. Member Administration I.2 Member Identification Cards I.5 Provider and Member Rights and Responsibilities
Dental Provider Manual - UPMC Health Plan
www.upmchealthplan.com2016 UPMC Dental Provider Manual Welcome 2 Advantages of Participating 2 UPMC Dental ... Electronic Funds Transfer Forms 57. 2 Welcome Welcome to UPMC Dental Advantage. We are committed ... dental plan, the plan that has been active the longest
Application for Health Care Coverage - UPMC Health Plan
www.upmchealthplan.comApplication for Health Care Coverage ... 1 of 15 Information About Health Care Coverage Who can use this application? You can use this application to apply for anyone in your family. You can still apply even if you don’t file a federal income tax return. ... Provides free health insurance for uninsured children and teens up to age 19 who ...
Subject Reason for Review UPMC Health Plan …
www.upmchealthplan.comMAY 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 & …
Evidence of Coverage - UPMC Health Plan
www.upmchealthplan.comJanuary 1 – December 31, 2017 Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of UPMC for Life HMO Deductible with Rx (HMO), HMO Rx (HMO) or
G Medical Management5.25.07 - UPMC Health Plan
www.upmchealthplan.comMedical 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 G.10 Special Needs Services G.12 Health Management Programs G.14 Clinical and Preventive Health Care Guidelines G.15 Member and Provider Surveys and Assessments
Membership Terminations for - UPMC Health Plan
www.upmchealthplan.comMembership Terminations for Month of , 20 Group Number: Group Name: Indicate below any changes to your billing address. Street Address:
Change Pay-to Address/Tax ID Change - UPMC Health Plan
www.upmchealthplan.comA 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.
QUICK REFERENCE GUIDE - UPMC Health Plan
www.upmchealthplan.comEffective 4-1-14 QUICK REFERENCE GUIDE Prior Authorization Provider/Member Services 1-800-425-7800 1-800-650-8762 This Quick Reference Guide (QRC) is …
Out-of-Network Care Claim Form - UPMC Health Plan
www.upmchealthplan.comOut-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
Claims Procedures - UPMC Health Plan
www.upmchealthplan.comSee Filing Methods, Claims Procedures, Chapter H. • Claims with eraser marks or white-out corrections may be returned. • If a mistake is made on a claim, the provider must submit a new claim. Claims must be submitted by established filing deadlines or they will be denied. See Deadlines, Claims Procedures, Chapter H.
Claims Procedures - UPMC Health Plan
www.upmchealthplan.comThese forms are for professional services performed in a provider’s office, hospital, or ancillary facility. (Provider-specific billing forms are not accepted.) See Required Fields on a CMS-1500 Claim Form, Claims Procedures, Chapter H. UB-04 forms These forms are for inpatient hospital services or ancillary services performed in the hospital.
UPMC Health Plan (Commercial) UPMC HEALTH PLAN …
www.upmchealthplan.comUPMC Health Plan (Commercial) UPMC Health Plan www.upmchealthplan.com © 2014 – 2015 All rights reserved. e 5 Health Maintenance Organization
UPMC for You (Medical Assistance) UPMC ... - UPMC Health …
www.upmchealthplan.comUPMC for You, affiliate of UPMC Health Plan, offers high-quality care to eligible Medical Assistance recipients in 40 counties in the Commonwealth of Pennsylvania. This care is achieved by combining the benefits of a managed care organization with
UPMC for Kids - Quality Health Insurance | UPMC Health Plan
www.upmchealthplan.comUPMC 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 Responsibilities D.21 UPMC for Kids Quick Reference Guide
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