MC Health Plan achieves high ratings in provider satisfaction

Jul. 2022Important Notices
"In 2021, 95 percent of physician practice survey respondents indicated they would recommend UPMC Health Plan to other physician practices. In addition, respondents ranked UPMC Health Plan in the 93rd percentile or higher on 17 of 19 questions in the 2021 Provider Satisfaction Survey.

UPMC Health Plan contracts with Symphony Performance Health (SPH) Analytics to measure provider satisfaction levels and to meet one or more NCQA Health Plan Accreditation Standards. SPH incorporates a percentile ranking to allow health plans to compare performance to a cohort of similar health plans who initiate a provider satisfaction survey.

You may be invited to participate in the 2022 survey that will begin next month. The survey is provided to a random sampling of primary care network providers and will ask for feedback on your experience with UPMC Health Plan. Watch for an invitation in the mail or via email next month!"

Recent Announcements

Clinical documentation required for hip, knee, and shoulder prior authorizations

As you know, UPMC Health Plan requires certain clinical documentation/notes in support of a request for prior authorization for hip, knee, and shoulder procedures in accordance with its established policies and procedures, in addition to CMS requirements that medical record documentation must support the medical necessity of the services requested.
Jul. 2025Important Notices

Clinical documentation required for hip, knee, and shoulder prior authorizations

As you know, UPMC Health Plan requires certain clinical documentation/notes in support of a request for prior authorization for hip, knee, and shoulder procedures in accordance with its established policies and procedures, in addition to CMS requirements that medical record documentation must support the medical necessity of the services requested.
Jul. 2025Important Notices

Understanding MP.PA.147

Understanding changes to the Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 policy
Jul. 2025Important Notices