Important update: UPMC Health Plan 835 readmits

May 2024Important Notices

UPMC Health Plan has discovered an issue with some of the Electronic Remittance Advice (835) data that was sent to providers. The issue—which is related to a systems enhancement—exists only within the 835 data. No issues have been found on Explanations of Payment or Explanations of Benefits.

The enhancement was implemented on April 25, 2024. As such, 835s created on or after April 26 may have been impacted.

Please note that we are working on a change that should resolve the issue within the next week, and we hope to provide a count of the providers and claims that were impacted. In the meantime, we have rolled back the 835 enhancements so that all 835s created on or after May 7 at 3 p.m. are correct.

If you have any questions about this matter, please contact your physician account executive or call Provider Services at 1-866-918-1595.

Recent Announcements

HPV Vaccination Resources

To help protect against cancers later in life, it is important to increase HPV vaccination rates in adolescents starting at age 9. According to the Centers for Disease Control and Prevention, HPV vaccination is routinely recommended at age 11 or 12, but the vaccine can be given starting at age 9.1 The Pennsylvania Cancer Coalition cites the following potential benefits of initiating the HPV vaccine series at age 9:2

Mar. 2025Important Notices

Special notice: Important policy changes

Effective May 1, 2025, the following policies will be retired and replaced with prior authorization policies. For more information, please visit upmchp.us/policiesandprocedures.

Mar. 2025Important Notices

CME Webinar: Essential Best Practices for Newborn Care: Ensuring Healthy Beginnings Through Comprehensive Care

Please join us for a live, CME-accredited webinar on Wednesday, May 7, from noon to 1 p.m. that will provide an overview of newborn care.

Feb. 2025Education/Webinars