Existing EFT payments set up with MetLife will remain unchanged, so no action is required on your part. Get the latest news and information about the Dental HMO/Managed Care Network^ and Products. Need to schedule by phone? Providers submitting claims through Interact with the Health Plan on claims issues via a messaging system. For additional information, please call SKYGEN Provider Services at 1-855-806-5193 or email providerservices@skygenusa.com. UPMC Dental Advantage offers competitive rates, convenient tools, and rapid reimbursement. Our provider portal is currently unavailable. Call our scheduling team at 1-800-533-8762 between 8 a.m. and 5 p.m. Monday through Friday. Resources for UPMC Health Plan/SKYGEN Dental Providers. You can request that your account be reactivated by contacting 1-800-937-0438. Provider OnLine Login Username Sign In If you forgot your user ID or need assistance, please call our Help Desk at 1-800-937-0438. plan detail, and claims. As a provider-led health insurer, we have a unique appreciation for our relationships with network doctors and care providers. Your dedicated network manager can answer questions and keep you current on new benefits, features, and products. UPMC Vision Advantage Electronically filed claims may be submitted in the following ways: Individual claim entry Not registered with UPMC Health Plan? Select MyUPMC to access your UPMC health information. For immediate help with a mental health crisis, call 988 for the Suicide & Crisis Lifeline. UPMC Community HealthChoices Dental Allowance Request Form. Important: Please provide your National Provider Identifier (NPI) when prompted. The portal for UPMC patients in Central Pa. 1 Childrens Hospital Drive, 4401 Penn Avenue, Floor 7, Pittsburgh, PA 15224 (Map) Children's North Ambulatory Surgery Center. MetLife is committed to helping our providers have a smooth transition to our new enrollment solution with as little disruption as possible. Discover the advantages of joining, and learn about resources available to you as a network provider. Search adult and pediatric providers and schedule appointments online. Patients of UPMC Cole should select the UPMC Cole Connect Patient Portal. Use billing software that allows the generation of a HIPAA-compliant 837 professional or institutional file. var dayNames = new Array("Sunday","Monday","Tuesday","Wednesday","Thursday","Friday","Saturday"); Dental . View members' historical coverage information. If your billing system transmits claims to UPMC via a clearinghouse please contact your vendor, or clearinghouse, for instructions on how to automate the processing of ERA's in an 835 format. The UPMC Presbyterian Dental Center at UPMC Montefiore offers preventive and follow-up dental care. Were happy to give you more information about becoming a UPMC Dental Advantage provider. About the Electronic Remittance Advice Submit claim forms to: Dominion National provides dental plans and administrative services to UPMC Health Plan members and maintains an extensive selection of participating dentists. Visit UPMC Health Plan's homepage. The online provider search lets you find a person who provides . For Providers About Contact . UPMC Community HealthChoices (CHC) Dental Advantage If you can't log in, contact Sales Support at 1-855-862-6515. Search adult and pediatric providers and schedule appointments online. Announcements DHMO providers will continue to receive paper checks and/or EFT payments as they do today, no action is required for DHMO payments. These claims are loaded into batches and immediately posted in preparation for adjudication. Browse doctors by specialty, procedure, service, or equipment to find the best fit for you! Determine a patient's primary insurance coverage. SIGN document.write(dayNames[now.getDay()] + ", " + monthNames[now.getMonth()] + " " + now.getDate() + ", " + year); User name: Medical Assistance: For nearly 30 yearsSKYGEN has been a trusted partner in a changing dental landscape, offering the tools and support you need to enhance your business while providing exceptional patient care. For Providers About Contact . Providers submitting claims through DenteMax is one of the largest leasable dental PPO networks in the United States. For a medical emergency, call 911 or go to the nearest emergency dept. For Providers About Contact Search. For member identification, submit the member's 11-digit ID number or the government-assigned identifiers for Medicare or Medical Assistance members. View UPMC's other Patient Portals. Sign in/Register I am a:MemberProviderEmployerProducer Sign In Please enter your username. This portion of the UPMC Health Plan's website is strictly related to HIPAA-mandated EDI transactions. 200 Lothrop Street Pittsburgh, PA 15213 412-647-8762 800-533-8762 Login This application is best viewed using Internet Explorer versions 6.0 and higher Login As Provider Network Login Name Password Home Forgot Password? Resources for Medical Providers Dental Providers Learn about the dental products UPMC Health Plan offers and the variety of resources available to network providers. Contact Our Dental Benefits Advisory Team, Join our UPMC Dental Advantage Provider Network, ONC 21st Century Cures Act Member Resource Center. Our Dental Benefits Advisory Team is ready to answer your call. Find out how to apply for the Preferred Dentist Program, Find out how to apply for Dental HMO/Managed Care Plan^, MetLife Dental Health Maintenance Organization (DHMO)/Managed Care Network^. For a medical emergency, call 911 or go to the nearest emergency dept. With UPMC Health Plan's Provider OnLine, you can: A provider office should appoint a staff member to serve as Security Officer. The Federal No Surprises Act within the Consolidated Appropriations Act of 2021 provides for out-of-network and balance billing protections for out-of-network Emergency, Air Ambulance, and certain services rendered at in-network facilities. For technical questions about the UPMC Central PA Portal, contact the Help Desk Mon. Read Dental Announcements For general assistance or inquiries regarding web portals or logins, please contact us here. Get the latest updates from UPMC Health Plan. View resources for medical providers, log into Provider OnLine, and get access to downloadable forms. 2022 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences. If you need help with your account, please call 1-866-884-8579. Search adult and pediatric providers and schedule appointments online. Our Provider Partner Update newsletter includes the latest news and information for network providers. Call our scheduling team at 1-800-533-8762 between 8 a.m. and 5 p.m. Monday through Friday. We are committed to offering industry-leading coverage to our memberssubject to federal, state, and local regulationsand to supporting our network providers as they deliver cost-effective, quality care. However, some plan providers may have been added or removed from the list (and/or contact information may have changed) since this directory was last updated. For a medical emergency, call 911 or go to the nearest emergency department. We offer personalized dental care at UPMC Montefiore in Pittsburgh and UPMC Cole in Coudersport and Port Allegany, Pa. Western Pa. Individual claim entry, known as Prelog, is available to providers with established Health Plan online accounts. Interested in joining UPMC Health Plans provider network? UPMC Health Plan and SKYGEN Clinical Criteria effective 12/18/2022. Federal Employees: Federal Employees Health Benefits Program (FEHB) Dental Advantage Our provider portal solutions make business transactions fast, simple and convenient, including: Submission of dental claims and prior authorizations . As a network provider, you can: Verify eligibilitycheck plan status with a member's ID, full name, and date of birth. Dental . Our clients of insurance companies, third-party administrators and various groups lease the DenteMax PPO network for use in their dental benefit plans in order to service their more than 20 million members nationwide. As a participating provider, you can access valuable information online by entering your user ID and password in the login box on this page. Call our scheduling team at 1-800-533-8762 between 8 a.m. and 5 p.m. Monday through Friday. UPMC Community HealthChoices is one of the managed care organizations selected to provide Community HealthChoices (CHC) services in Pennsylvania to those who qualify for Medical Assistance and also qualify for Medicare or require a nursing facility level of care. Call our scheduling team at 1-800-533-8762 between 8 a.m. and 5 p.m. Monday through Friday. For a medical emergency, call 911 or go to the nearest emergency department. Pittsburgh, PA 15230-1600, Join our UPMC Dental Advantage Provider Network, ONC 21st Century Cures Act Member Resource Center. 2022 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences. Learn more about the Preferred DentistProgram and MetLife Dental Health Maintenance Organization (DHMO)/Managed Care Network^ and benefits like an increased patient base, continuing education at NO CHARGE, and more. // Array of month Names To request a direct interface of an 835 formatted ERA file, from this website or via PGP encrypted file transfer, please complete the 835 Request Form and send via email to HealthPlanEDI@upmc.edu. Log In to the Dental Advantage Provider Portal Announcements Get the latest updates from UPMC Health Plan. Make an appointment Need to schedule by phone? We also treat serious dental issues to help you keep smiling. Find a Doctor or Provider. Find a UPMC health care facility close to you quickly by browsing by region. Vision . This person will: If you have not accessed your Provider OnLine account in the past six months, your account may be disabled. Access your UPMC information in MyUPMC. Providers are able to submit claims directly without incurring clearinghouse expenses. UPMC Dental Advantage Provider Portal Visit our secure website, where network providers can sign in and complete most administrative tasks. Emdeon should use payer ID 23281. Call our scheduling team at 1-800-533-8762 between 8 a.m. and 5 p.m. Monday through Friday. Patients of UPMC Cole should select the UPMC Cole Connect Patient Portal.