UPMC Health Plan
Also covers / subsidiaries: UPMC, UPMC for You, UPMC for Life
Core Payer & Clearinghouse Profile
Electronic Payer ID
23281
From a secondary payer guide — verify against UPMC's own EDI documentation.
Timely Filing Limit (TFL)
90 days (per secondary source — confirm in the Provider Manual)
Appeal Window
Varies — confirm via portal / clearinghouse
Clearinghouse Gateway
EDI plus direct claim submission via Provider OnLine
Provider Services
Varies — confirm via portal / clearinghouse
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Varies — confirm via portal / clearinghouse
Provider Portal
https://provideronline.upmchp.com/
Pennsylvania plan with commercial, UPMC for You (Medicaid), and UPMC for Life (Medicare Advantage) lines. Payer ID and filing window are from a secondary aggregator — confirm against UPMC's EDI docs.
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for UPMC Health Plan.
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under UPMC Health Plan.
| Clearinghouse Name | Electronic Payer ID | Status | Enrollment | Supported Services |
|---|---|---|---|---|
| Upmc Dental Advantage | 23281 | Non-Par | None | 837P837I835 ERA |
| Upmc Health Plan | 10288 | Non-Par | None | 837P837I270/271Dental |
| Upmc Health Plan | 23281 | Non-Par | Required | 837P837I835 ERA |
Resolution Tools for UPMC Health Plan Claims
Values vary by plan, line of business, and provider agreement. Confirm in the payer portal or with your clearinghouse gateway before submitting electronic claims.
Tired of Chasing UPMC Health Plan Denials & Delayed Payments?
Aethera's billing specialists work UPMC Health Plan every day — handling EDI clearinghouse rejects, prior authorizations, payment posting, and 30-day AR aging recovery.