Coverage profile
Work UPMC Health Plan across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with UPMC Health Plan.
Coordination of benefits
Real-time checkThe Substrate Eligibility Agent can check coordination of benefits for other active coverage and primary or secondary order with UPMC Health Plan.
Other aliases
Also known as
- 10288
- 23281
- 23281MA
- 23281MAP
- 2803
- 7543
- 95216
- U3281
- UPMC
- UPMCD
- UPMC Dental Advantage
- UPMC Health Plan (TriState)
- University of Pittsburgh Medical Center Dental Advantage
- University of Pittsburgh Medical Center Health Plan
- UPMCHTHPLN
Frequently asked questions
UPMC Health Plan payer FAQs
What is the payer ID for UPMC Health Plan?
The primary payer ID for UPMC Health Plan is 23281. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What are the 837 payer IDs for UPMC Health Plan?
The 837P and 837I payer ID for UPMC Health Plan is 23281 via Stedi.
What is the 835 payer ID for UPMC Health Plan?
The 835 payer ID for UPMC Health Plan is 23281 via Stedi.
What is the 270 payer ID for UPMC Health Plan?
The 270 payer IDs for UPMC Health Plan are 23281 via Stedi and 23281 via Availity.
What is the 276 payer ID for UPMC Health Plan?
The 276 payer IDs for UPMC Health Plan are 23281 via Stedi and 23281 via Availity.
What is coordination of benefits on UPMC Health Plan?
A coordination of benefits check for UPMC Health Plan can return other active plans, whether coverage overlaps, and a primary or secondary order when that order can be determined. Results can be partial. Enrollment is not required for this check. It is separate from the 270 eligibility payer ID.
What states does UPMC Health Plan operate in?
UPMC Health Plan operates in OH and PA.
Routing reference
UPMC Health Plan payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | UPMC Health PlanSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | OH, PASource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | 23281Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 23281Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 23281Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 23281Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 23281Source: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 23281Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | 23281Source: Availity payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: UPMC Health Plan. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer ID; matched record: UPMC HEALTH PLAN. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: UPMC Health Plan. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Payer contact directory
UPMC Health Plan phone and fax numbers
Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.
- Payer phone
- (412) 434-1200UPMC HEALTH PLAN
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(412) 434-1200 |
|
Phone and fax numbers sourced directly from the payer response
Phone menu guides
- (844) 860-9303UPMC Community HealthChoices Member and Provider Line