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// Array of day names Advantage Dental Provider Portal We have moved! Need to schedule by phone? It requires the recipient's Practice or Billing System have the ability to automate loading of a file in the mandated format. Dental . Need Help? If you need assistance, please call our Help Desk at 1-800-937-0438. Call our scheduling team at 1-800-533-8762 between 8 a.m. and 5 p.m. Monday through Friday. Please be advised MetLife has contracted VPoint to provide credentialing and recredentialing services on MetLife's behalf. To learn how to register, watch our instructional Provider OnLine registration video. For more information on dental services, view the UPMC Community HealthChoices Handbook . Home & Community-Based Services . It is important that you respond to VPoint to ensure your continued relationship with MetLife. Participants who need help finding a dental provider, or have questions about their dental benefit, can call the UPMC Community HealthChoices HealthCare Concierge team at 1-844-833-0523 (TTY: 711). Pharmacy . Through MetDental, participating Dentists can view rosters, search for Explanation of Payment statements, download Facility Reference Guides, and more. 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^. Receive 24-hour access to claims and coverage information. Dental Care at UPMC Our dental experts can help you to put your best face forward. Need to schedule by phone? Provider OnLine Features With UPMC Health Plan's Provider OnLine, you can: Sign in/Register I am a:MemberProviderEmployerProducer Sign In Please enter your username. The portal for all UPMC patients EXCEPT those in Central Pa. Make an appointment DHMO providers will have the ability to manage all payments under one experience on the Zelis platform in future phases. Resources for Dental Providers Vision Providers Message your doctor Send a private, secure message to your provider, anytime. To learn how to register, watch our instructional Provider OnLine registration video. Health Care Claim Status Request & Response (276/277), Provider OnLine Account Administrator Application, 837 Companion Document Professional Claims File, 837 Companion Document Institutional Claims File, Desktop Setup for File Submission and Implementation, Join our UPMC Dental Advantage Provider Network, ONC 21st Century Cures Act Member Resource Center. Someone will contact you. 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. plan detail, and claims. As the only provider-led health insurer in western Pennsylvania, we recognize the importance of partnership with network physicians and sensitivity to doctor-patient relationships. For Providers About Contact . Find listings of the care providers we partner with including doctors, hospitals, pharmacies . Need to schedule by phone? Resources for UPMC Health Plan/SKYGEN Dental Providers. With UPMC Health Plan's Provider OnLine, you can: A provider office should appoint a staff member to serve as Security Officer. UPMC Community HealthChoices Dental Allowance Request Form. Providers who have existing relationships with clearinghouses such as WebMD (UPMC Health Plan Payer ID: 23281), NDC, and HDS can continue to transmit claims in the format produced by their billing software. Existing EFT payments set up with MetLife will remain unchanged, so no action is required on your part. Read Dental Announcements The portal for UPMC patients in Central Pa. You can follow up with additional questions to the HealthPlanEDI@upmc.edu distribution group. Pittsburgh, PA 15230-1600. TTY: 711. If you need help with your account, please call 1-866-884-8579. Providers submitting claims through If you forgot your User ID or need assistance, please call our Help Desk at 1-800-937-0438. This feature allows direct submission of both professional (HCFA/CMS-1500) and institutional (UB-92) claims via a user-friendly interface, using the Internet's highest level of security to make the process safe and easy. var dayNames = new Array("Sunday","Monday","Tuesday","Wednesday","Thursday","Friday","Saturday"); To verify eligibility and plan information, please call: Claims and pre-determinations should be submitted using one of the methods below: Clearinghouse Submission: Log In to the Dental Advantage Provider Portal Announcements Get the latest updates from UPMC Health Plan. Announcements UPMC Health Plan and SKYGEN Product Guide. You can request that your account be reactivated by contacting 1-800-937-0438. DenteMax is one of the largest leasable dental PPO networks in the United States. Your Username or Password? You also can register to join the network. The portal for UPMC Cole patients receiving inpatient care. Get the latest updates from UPMC Health Plan. Get an immediate response if mistakes are made submitting a claim (using HIPAA 837 forms). Contact Our Dental Benefits Advisory Team, Join our UPMC Dental Advantage Provider Network, ONC 21st Century Cures Act Member Resource Center. Claim files are transmitted using a secure FTP process that does not require data encryption prior to transmission. Call our scheduling team at 1-800-533-8762 between 8 a.m. and 5 p.m. Monday through Friday. More Contact Options ; . Login/Register. As a participating provider, you can access valuable information via Provider OnLine. Call our scheduling team at 1-800-533-8762 between 8 a.m. and 5 p.m. Monday through Friday. 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. Find care with UPMC Health Plan's Provider Directory. As a network dentist, youll get help with claims status, eligibility, and more. 2023 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences, Supplemental content provided by Healthwise, Incorporated. Vision . Find a UPMC health care facility close to you quickly by browsing by region. For immediate help with a mental health crisis, call 988 for the Suicide & Crisis Lifeline. 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 dept. For technical questions about the UPMC Central PA Portal, contact the Help Desk Mon. Thank you for being a part of the UPMC Dental Advantage/UPMC Vision Advantage network. Member Login. In the meantime, if you need to verify eligibility, plan information or submit a claim, please follow the instructions below. Vision . Electronically filed claims may be submitted in the following ways: Individual claim entry Federal Employees: Federal Employees Health Benefits Program (FEHB) Dental Advantage Find out how Medical . Individual claim entry, known as Prelog, is available to providers with established Health Plan online accounts. Chat with a UPMC Health Plan provider service representative in real time. For immediate help with a mental health crisis, call 988 for the Suicide & Crisis Lifeline. Search adult and pediatric providers and schedule appointments online. Give us feedback on Provider OnLine. Our Dental Benefits Advisory Team is ready to answer your call. Learn about and take advantage of the resources available to you as a network provider. I am a: Login. Not a UPMC Central PA Portal Patient? 412-647-8762 Forgot Password? var now = new Date(); UPMC Dental Advantage For a medical emergency, call 911 or go to the nearest emergency department. UPMC Health Plan's claims processing system allows providers to take advantage of enhanced access to information, including the ability to immediately correct claims that have missing information, incorrect procedure codes, or other errors. Sign in to UPMC Cole Connect Patient Portal. Were happy to give you more information about becoming a UPMC Dental Advantage provider. User Login. Have a sample 837 file exported from their billing system containing only UPMC Health Plan claims. About the Electronic Remittance Advice Find out how to apply for Dental HMO/Managed Care Plan^. Dentistry - Find a Doctor | UPMC Need Care? Home & Community-Based Services . You may search for dentists by zip code, proximity, and type on the provider search tool above for any of the dental options. If you choose this option for claims submission and you do not have a Provider OnLine account, complete this form to sign up. This portion of the UPMC Health Plan's website is strictly related to HIPAA-mandated EDI transactions. First-time users can create an account by contacting their office Provider OnLine Account Administrator or by calling 1-800-937-0438. Register. 2599 Wexford Bayne Road, Sewickley, PA 15143 (Map) 724-933-3700. Online Login: UserID I forgot my user id (Members Only) : There was an error with the Pass through from your Public Website. 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. The provider's office can enter claims and verify if they have been accepted and are ready for adjudication. UPMC Dental Advantage offers UPMC employees two options Standard and Premium with a network of fully credentialed dentists. I am a: Login. So can you. Our dental health team at UPMC Cole offers high-quality family dental care at affordable pricing. 2022 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences. 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. Your health information, right at your fingertips. View UPMC's other Patient Portals. Dominion National provides dental plans and administrative services to UPMC Health Plan members and maintains an extensive selection of participating dentists. We offer personalized dental care at UPMC Montefiore in Pittsburgh and UPMC Cole in Coudersport and Port Allegany, Pa. Western Pa. To learn more, visit healthwise.org. Login to Provider Online. UPMC Health Plan and SKYGEN Provider Manual. These clearinghouses are then responsible for reformatting these claims to meet HIPAA standards and passing the claims on to the Health Plan. For nearly 30 years SKYGEN 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. SIGN UPMC Dental Advantage offers competitive rates, convenient tools, and rapid reimbursement. Submission of dental claims and prior authorizations, Member status and eligibility determination. For a medical emergency, call 911 or go to the nearest emergency dept. When care is coordinated, submit the referring provider NPI if available, as well as the name and UPIN. Grant access to Provider OnLine to certain staff members on the provider's behalf. Forgot 1 Childrens Hospital Drive, 4401 Penn Avenue, Floor 7, Pittsburgh, PA 15224 (Map) Children's North Ambulatory Surgery Center. For Providers About Contact . Our provider portal solutions make business transactions fast, simple and convenient, including: Submission of dental claims and prior authorizations . Contact Us Current Members. Browse doctors by specialty, procedure, service, or equipment to find the best fit for you! Dental . These resources, such as the Provider Manual, can assist you with administrative and practice needs. Get the latest resources, news, and announcements from UPMC Health Plan for participating providers. Forgot username or password? *Administered by National Vision Administrators, Join our UPMC Dental Advantage Provider Network, ONC 21st Century Cures Act Member Resource Center. We apologize for this inconvenience and look forward to serving you the next time you sign in. Medical Assistance: Call your provider's office or 1-800-533-8762. View up-to-date eligibility, PCP information, and covered benefits. Need to schedule by phone? First-time users can create an account by contacting their office Provider OnLine Account Administrator or by calling 1-800-937-0438. UPMC CCP-South Fayette. Claims should be submitted using one of the methods below: Clearinghouse Submission: Not registered with UPMC Health Plan? var year = now.getFullYear() Have the ability to download and install a free Active-X secure FTP add-on. var monthNames = new Array( 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. Per HIPAA, the only permissible format for an electronic remittance advice (ERA), in a data file, is the ANSI ASC X12.835, Health Care Claim Payment/ Advice, commonly referred to as an 835. Submit claim forms to: For immediate help with a mental health crisis, call 988 for the Suicide & Crisis Lifeline. Paper Claim Submission: View resources for medical providers, log into Provider OnLine, and get access to downloadable forms. UPMC Health Plan and SKYGEN Dental Provider Quick Reference Guide. . Search adult and pediatric providers and schedule appointments online. Forgot username or password? Providers. Welcome to UPMC for You! How to Login? Find care with UPMC Health Plan's Provider Directory. Dentists in our network enjoy top-notch support that makes it easier to run a successful practice. So many helpful features. Providers are able to submit claims directly without incurring clearinghouse expenses. UPMC for You Dental Advantage document.write(dayNames[now.getDay()] + ", " + monthNames[now.getMonth()] + " " + now.getDate() + ", " + year); User name: Please submit the National Provider Identifier (NPI), along with the tax ID and the provider ID as assigned by UPMC Health Plan. 2023 MetLife Services and Solutions, LLC, VPoint Credentialing and Recredentialing Services. Search adult and pediatric providers and schedule appointments online. Get the latest updates from UPMC Health Plan, including updates to our Provider COVID-19 FAQ and Appendix A COVID-19 Special Coverage and Payment Policy. . For a medical emergency, call 911 or go to the nearest emergency department. Register. Your Username or Password? Learn how to get one now. Determine a patient's primary insurance coverage. How to Login? The UPMC Presbyterian Dental Center at UPMC Montefiore offers preventive and follow-up dental care. Serve as the provider practices primary contact with UPMC Health Plan regarding Provider OnLine security issues. Please be advised Zelis is the new payment solution for MetLife claim payments. Need to schedule by phone? *Disclaimer: This online directory provides a list of UPMC Health Plan providers, and the information contained here is updated periodically. The UPMC Presbyterian Dental Center at UPMC Montefiore offers preventive and follow-up dental care. View plansget vision and dental plan information prior to the member's visit. Advantage Dental's Home Support Office is now located at 63140 Britta Street Suite D104, Bend, Oregon 97703 We will be making a few exciting system changes over the next several weeks to help improve provider and member experience! Medicare: UPMC for Life Dental Advantage (University of Pittsburgh retirees only) Use billing software that allows the generation of a HIPAA-compliant 837 professional or institutional file. Our Dental Advantage Newsletter includes the latest news and information for network providers. For immediate help with a mental health crisis, call 988 for the Suicide & Crisis Lifeline. Video Visit. Login/Register. Behavioral Health . Providers may use the standard PGP encryption process in addition to the secure FTP, if additional data security is desired.

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