Get virtual care Schedule a video visit with your regular provider. Don't have one? Your session has ended, thank you for using UPMC Health Plan OnLine. Medical Assistance: Your place to stay in control. // patched for y2k bug! Provider Directory | Find Care | UPMC Health Plan For more information on dental services, view the UPMC Community HealthChoices Handbook . Resources for Medical Providers Dental Providers Learn about the dental products UPMC Health Plan offers and the variety of resources available to network providers. For immediate help with a mental health crisis, call 988 for the Suicide & Crisis Lifeline. var now = new Date(); When care is coordinated, submit the referring provider NPI if available, as well as the name and UPIN. Patients of UPMC Cole should select the UPMC Cole Connect Patient Portal. . Dental . Get an immediate response if mistakes are made submitting a claim (using HIPAA 837 forms). Login to Provider Online. 200 Lothrop Street Pittsburgh, PA 15213 412-647-8762 800-533-8762 Start Here. For additional information, please call SKYGEN Provider Services at 1-855-806-5193 or email providerservices@skygenusa.com. For immediate help with a mental health crisis, call 988 for the Suicide & Crisis Lifeline. If you forgot your User ID or need assistance, please call our Help Desk at 1-800-937-0438. TTY: 711. Grant access to Provider OnLine to certain staff members on the provider's behalf. Browse doctors by specialty, procedure, service, or equipment to find the best fit for you! Our clients of insurance companies, third-party administrators and various groups lease the DenteMax PPO network for use in their dental benefit plans in order to service their more than 20 million members nationwide. At this time, only PPO providers currently receiving their payments by checks will be included in this phase. Thank you for being a part of the UPMC Dental Advantage/UPMC Vision Advantage network. . Resources for Dental Providers Vision Providers Make an appointment Advantage Dental's Home Support Office is now located at 63140 Britta Street Suite D104, Bend, Oregon 97703 We will be making a few exciting system changes over the next several weeks to help improve provider and member experience! UPMC Community HealthChoices (CHC) Dental Advantage UPMC Health Plan's claims processing system allows providers to take advantage of enhanced access to information, including the ability to immediately correct claims that have missing information, incorrect procedure codes, or other errors. You may search for dentists by zip code, proximity, and type on the provider search tool above for any of the dental options. UPMC Dental Advantage For immediate help with a mental health crisis, call 988 for the Suicide & Crisis Lifeline. Have a sample 837 file exported from their billing system containing only UPMC Health Plan claims. PO Box 1600 As a network provider, you can: Verify eligibilitycheck plan status with a member's ID, full name, and date of birth. Find a Doctor or Provider. As a participating provider, you can access valuable information via Provider OnLine. UPMC Dental Advantage Provider Portal Visit our secure website, where network providers can sign in and complete most administrative tasks. We apologize for this inconvenience and look forward to serving you the next time you sign in. Existing EFT payments set up with MetLife will remain unchanged, so no action is required on your part. Discover the advantages of joining, and learn about resources available to you as a network provider. Dental and Vision Providers - UPMC Health Plan For Medical Providers | UPMC Health Plan 205 Millers Run Road, Suite 300, Bridgeville, PA 15017 (Map) 724-934-3334. We also treat serious dental issues to help you keep smiling. Pittsburgh, PA 15213 Make Provider OnLine security requests to UPMC Health Plan on behalf of other staff members. If you have questions while you are completing the form, contact our Web Support Services at 1-800-937-0438. For Providers | UPMC Community HealthChoices Chat with a UPMC Health Plan provider service representative in real time. About the Electronic Remittance Advice For a medical emergency, call 911 or go to the nearest emergency department. Vision . To learn how to register, watch our instructional Provider OnLine registration video. Forgot Password? UPMC for You Dental Advantage Advantage Dental Provider Portal We have moved! For a medical emergency, call 911 or go to the nearest emergency department. As a network dentist, youll get help with claims status, eligibility, and more. With UPMC Health Plan's Provider OnLine, you can: A provider office should appoint a staff member to serve as Security Officer. View members' historical coverage information. Contact Our Dental Benefits Advisory Team, Join our UPMC Dental Advantage Provider Network, ONC 21st Century Cures Act Member Resource Center. Access your UPMC information in MyUPMC. "January","February","March","April","May","June","July","August","September","October","November","December"); Paper Claim Submission: 2023 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences, Supplemental content provided by Healthwise, Incorporated. Use billing software that allows the generation of a HIPAA-compliant 837 professional or institutional file. It requires the recipient's Practice or Billing System have the ability to automate loading of a file in the mandated format. the introduction of UPMC Dental Advantage. PO Box 1600 Dentistry - Find a Doctor | UPMC Need to schedule by phone? Watch and learn more about Provider OnLine, Appendix A COVID-19 Special Coverage and Payment Policy, NSA Negotiation Information for Providers, Provider Disclosure of Ownership and Control, Expedited Provider Appeal Certification Form, EPSDT Clinical and Operational Guidelines, Continuing Medical Education (CME) Resources, Join our UPMC Dental Advantage Provider Network, ONC 21st Century Cures Act Member Resource Center. Submit claim forms to: Not a UPMC Central PA Portal Patient? Provider Directory | Find Care | UPMC Health Plan Register. Not registered with UPMC Health Plan? Get the latest updates from UPMC Health Plan, including updates to our Provider COVID-19 FAQ and Appendix A COVID-19 Special Coverage and Payment Policy. 800-533-8762. For Providers About Contact . Dental Coverage | UPMC Community HealthChoices To request a direct interface of an 835 formatted ERA file, from this website or via PGP encrypted file transfer, please complete the 835 Request Form and send via email to HealthPlanEDI@upmc.edu. Get the latest news and information about the Dental HMO/Managed Care Network^ and Products. If you are interested in HIPAA-compliant EDI file submission, please refer to the additional set-up documents on this website. UPMC Vision Advantage DHMO providers will have the ability to manage all payments under one experience on the Zelis platform in future phases. We are committed to offering industry-leading coverage to our memberssubject to federal, state, and local regulationsand to supporting our network providers as they deliver cost-effective, quality care. UPMC Health Plan and SKYGEN Dental Provider Quick Reference Guide. For immediate help with a mental health crisis, call 988 for the Suicide & Crisis Lifeline. UPMC Dental Advantage Medicare Provider Services 1-844-761-0081 Claims and pre-determinations should be submitted using one of the methods below: Clearinghouse Submission: Providers submitting claims through Emdeon should use payer ID 23281. These resources, such as the Provider Manual, can assist you with administrative and practice needs. For immediate help with a mental health crisis, call 988 for the Suicide & Crisis Lifeline. Log In to the Dental Advantage Provider Portal Announcements Get the latest updates from UPMC Health Plan. If you can't log in, contact Sales Support at 1-855-862-6515. Online Login: UserID I forgot my user id (Members Only) : There was an error with the Pass through from your Public Website. Search adult and pediatric providers and schedule appointments online. First-time users can create a Provider OnLine account. Message your doctor Send a private, secure message to your provider, anytime. Learn more about the Preferred DentistProgram and MetLife Dental Health Maintenance Organization (DHMO)/Managed Care Network^ and benefits like an increased patient base, continuing education at NO CHARGE, and more. Providers who have existing relationships with clearinghouses such as WebMD (UPMC Health Plan Payer ID: 23281), NDC, and HDS can continue to transmit claims in the format produced by their billing software. How to Login? Have the ability to download and install a free Active-X secure FTP add-on. If you need assistance, please call our Help Desk at 1-800-937-0438. 2599 Wexford Bayne Road, Sewickley, PA 15143 (Map) 724-933-3700. Were happy to give you more information about becoming a UPMC Dental Advantage provider. 2022 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences. DenteMax | DenteMax Dental PPO Network Please submit the National Provider Identifier (NPI), along with the tax ID and the provider ID as assigned by UPMC Health Plan. *Administered by National Vision Administrators, Join our UPMC Dental Advantage Provider Network, ONC 21st Century Cures Act Member Resource Center. For a medical emergency, call 911 or go to the nearest emergency department. Emdeon should use payer ID 23281. Find a Doctor, Specialist, or Provider | UPMC 412-647-8762 Forgot Find care with UPMC Health Plan's Provider Directory. Find a UPMC health care facility close to you quickly by browsing by region. For general assistance or inquiries regarding web portals or logins, please contact us here. . Start Here. Providers are able to submit claims directly without incurring clearinghouse expenses. for a doctor or specialist. Batch file submissions 2022 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences. Our dental health team at UPMC Cole offers high-quality family dental care at affordable pricing. Medicaid and Medical Assistance Plans | UPMC for You For a medical emergency, call 911 or go to the nearest emergency dept. Login::. - UPMC For a medical emergency, call 911 or go to the nearest emergency dept. Call our scheduling team at 1-800-533-8762 between 8 a.m. and 5 p.m. Monday through Friday. Advantage Dental Provider Portal In the meantime, if you need to verify eligibility, plan information or submit a claim, please follow the instructions below. Find care with UPMC Health Plan's Provider Directory. Our provider portal is currently unavailable. View up-to-date eligibility, PCP information, and covered benefits.