Information & Resources
Find all of UPMC Health Plan’s documents, resources, manuals, guidelines, forms, and other information for providers in downloadable formats.
Manuals
Download our Provider Manual and Policies & Procedures Manual here.
Download and View Our Manuals
Guidelines
Find all information regarding guidelines in downloadable formats including our Clinical Practice Guidelines, Quality Assurance, and EPSDT Clinical & Operational Guidelines.
Find Information About Our Guidelines
Forms
Access downloadable forms including those for Medical Prior Authorization and Pharmacy Prior Authorization.
View Forms
Other Information
Find all other provider information here including Pharmacy Resources, Patient Health, and the Quality Partners incentive program.
Find All Other Provider Information
Provider Telehealth Guidelines and Toolkit
Telehealth services may be reimbursed by participating providers when they follow UPMC Health Plan policies. Read our provider telehealth guidelines for details.
Provider Telehealth Guidelines and Toolkit
Centers of Excellence
UPMC Health Plan has established credentialed Centers of Excellence that include interdisciplinary teams with extensive experience in specific specialties. The members of these teams have the necessary expertise to coordinate follow-up care and education, as needed. The goal of these Centers of Excellence is to help members receive the best possible care, in the safest of environments.
View our Centers of Excellence