UPMC for Kids
What age does UPMC for Kids terminate?
What is the end of their 19th birthday month.
What are members covered for under UPMC for You?
What is medical, dental, vision, behavioral health, pharmacy.
What two ways can members file complaints?
What is over the phone or in writing.
How long does UPMC have to process claims?
What is 30days.
What systems do we use to take payments?
What is ACI and Govolution.
How long do parents have to complete their renewals?
What is 90days.
Members are allowed to get dentures how often?
What is once per lifetime.
How long do members have to file a continuation of care complaint?
What is 10days.
What do all providers need for a claim to be paid?
What is a promise ID.
How many days to parents have to make their renewal premium payments?
What is 90 days.
What allows us to back date coverage for a newborn's date of birth?
What is required on all UPMC for You cards?
What is a PCP
What is the address for C&G?
What is C&G PO BOX 2939 Pittsburgh PA 15230.
When are we allowed to do a one time courtesy billing adjustment?
What is non par lab.
What should we never do with a saved payment?
What is verify it for the person
What are the premium groups for UPMC for Kids East?
What is 58.75 dollars, 82.25 dollars, 94.00 dollars, and 249.84 dollars.
What is the max copay for Inpatient Hospital Rehab Services?
What is 21.00 dollars.
What is needed for an expedited decision to be approved?
What is a provider certification.
When are we not able to adjust balance billing?
When the provider is non-par.
What is the first date available for autopay?
What is the 20th of every month
At what age is a PA required for Chiropractic benefits and how many visits are covered?
What is under 7 years old and 20 visits.
Who do members speak with to switch their MCO carrier and what is the phone number?
What is PA Enrollment and 800 440 3989.
Name two complaint cases that do not have 2nd level appeal rights?
What is Non-covered services, authorization for out of area provider, coverage of services, discrimination, experimental/investigational, benefits, cost share.
How long is the NPI# for a provider?
What is 10 digits.
Govolution payments take how long to show on the members account?