UPMC for You — Pennsylvania — Medicaid
Managed MedicaidVerified · August 2026Pennsylvania
⚠ Pennsylvania-specific contact information: Heads up
- Standard timely filing
- 90 days
- Appeal filing window
- Not yet published
- Prior authorization
- Not yet published
- Appeal channel
- Not yet published
- Provider portal
- Available
- Verification
- Verified · August 2026by AR Guide team
Payer Contact Finder
Know before you call
Provider portal
Provider OnLine (opens in a new tab)UPMC Health Plan Provider OnLine — claims, eligibility and prior authorization.
- Standard filing limit
- 90 days
- Counted from
- date of service
- Appeal filing limit
- Not stated
- Appeal window from
- Not stated
- Notes
- UPMC for You (Medical Assistance) claims must be sent within 90 days of the date of service (official provider manual).
- Provider portal
- https://www.upmchealthplan.com/providers/medical (opens in a new tab)Verified · August 2026Verified Aug 18, 2026 · Official web pageView source (opens in a new tab)
UPMC Health Plan Provider OnLine — claims, eligibility and prior authorization.
- Provider Services
- 866-918-1595Verified · August 2026Verified Aug 18, 2026 · Official web pageView source (opens in a new tab)
UPMC for You Provider Services — claims, coverage and prior authorization questions (official provider manual; Mon–Fri).
- Claims
- 866-918-1595Verified · August 2026Verified Aug 18, 2026 · Official web pageView source (opens in a new tab)
Same Provider Services line handles claims inquiries for UPMC for You.
Every contact is individually source-tracked and shows the date it was last verified. A green “Verified” badge only appears when a source and verification date exist.
- Features
- claims, eligibility, enrollment
- Registration required
- Yes
- Notes
- UPMC Health Plan Provider OnLine — claims, eligibility and prior authorization.
Provider portal
UPMC Health Plan Provider OnLine — claims, eligibility and prior authorization.
Referrals
Not yet published for this entry. Referral requirements and retro-referral rules are published only when verified against a source.
Appeals
Not yet published for this entry. Appeal levels, filing channels and external-review options are published only when verified against a source.
Documentation requirements
Not yet published for this entry. Required documentation for appeals and additional-information requests is published only when verified against a source.
- Common CARCs
- 19729
- Common RARCs
- MA119N29
- Top reasons
- Precertification / prior authorization / notification absent (CARC 197) — the payer documents authorization requirements for covered services.; Timely filing (CARC 29) — this plan documents a 90-day claim-filing window from the date of service; claims filed after the window are denied for exceeding the time limit (paired RARC MA119: provider-level adjustment for late claim filing).
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Recent updates
Change log
- Verified provider portal · Aug 18, 2026UPMC for You — Provider Manual (Welcome and Key Contacts)
- Verified provider services contact · Aug 18, 2026UPMC for You — Provider Manual (Welcome and Key Contacts)
- Verified claims contact · Aug 18, 2026UPMC for You — Provider Manual (Welcome and Key Contacts)
- Verified timely filing · Aug 18, 2026UPMC for You (Medical Assistance) — Provider Manual
- Verified portal information · Aug 18, 2026UPMC for You — Provider Manual (Welcome and Key Contacts)
- Verified denial patterns · Aug 18, 2026UPMC for You (Medical Assistance) — Prior AuthorizationUPMC for You (Medical Assistance) — Provider Manual
- Entry last reviewed · Aug 18, 2026UPMC for You — Provider Manual (Welcome and Key Contacts)UPMC for You (Medical Assistance) — Provider Manual
Contact information is provided for reference and is verified against the cited source as of the date shown. Payer contact information may change. Always confirm the appropriate contact for the member's plan and claim.
Source & verification
Directory record
- Geographic scope
- Pennsylvania
- Line of business
- Managed Medicaid
- Last reviewed
- Aug 18, 2026
- Verified by
- AR Guide team
- UPMC for You — Provider Manual (Welcome and Key Contacts) — https://www.upmchealthplan.com/docs/providers/2021_ProviderManual_A.pdf
- UPMC for You (Medical Assistance) — Provider Manual — https://www.upmchealthplan.com/docs/providers/2021_ProviderManual_E2.pdf
- UPMC for You (Medical Assistance) — Prior Authorization — https://www.upmchealthplan.com/providers/medical/resources/forms/medical-pa