Provider OnLine Enhancements
Apr. 2025Important Notices
Provider OnLine Enhancements
Provider OnLine will be launching enhancements to the authorization process on April 18, 2025.
The enhancement will include the following updates:
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Present Type of Care selections based on details entered on the authorization form.
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Display if prior authorization is required for the procedure entered on the authorization form.
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Display ‘My Recent Authorizations’ to allow a user to easily see authorizations they entered within the last four calendar days.
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Enhanced page design for authorization entry and inquiry.
Please view the quick reference guide and tutorial video at your convenience.
Recent Announcements
Important Notice Regarding Prior Authorizations for MP.PA.147
UPMC Health Plan previously communicated that prior authorizations would be required under policy Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 effective June 1, 2025. However, the prior authorization requirement will be paused until Sept. 1, 2025.Jul. 2025Important Notices
Important Notice Regarding Prior Authorizations for MP.PA.147
UPMC Health Plan previously communicated that prior authorizations would be required under policy Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 effective June 1, 2025. However, the prior authorization requirement will be paused until Sept. 1, 2025.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