Complete reinstated PROMISe ID enrollment requirements to avoid claim denials for Medical Assistance, CHC, and CHIP
Jul. 2023Important Notices
All service locations must comply with the reinstated PROMISe™ ID enrollment requirements to avoid claim denials for patients with UPMC for You (Medical Assistance), UPMC for Kids (Children’s Health Insurance Program/CHIP), and UPMC Community HealthChoices coverage for service dates starting Sept. 1, 2023. Providers who offer, order, refer, or prescribe services for patients with these coverage types must take the following steps to comply with the requirements:
- Enroll every service location where they see members with the Department of Human Services (DHS).
- Obtain a PROMISe ID (also known as a Medicaid ID or MPI) and revalidate these locations as required every five years.
- Log in to PROMISe to check the revalidation dates of each service location and submit revalidation applications at least 60 days prior to the revalidation dates.
- Enroll any service locations that are not listed in PROMISe.
Review Medical Assistance Bulletin 99-21-01 and Medical Assistance Bulletin 99-22-11 to learn more about the reinstatement of provider enrollment requirements.
Contact DHS with questions on provider enrollment, revalidation, enrollment fees, site visits, and criminal background checks. You can reach DHS at 1-800-537-8862 (option 2, option 4, option 2).
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