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University of Pittsburgh Medical Center Health Plan

University of Pittsburgh Medical Center Health Plan

This page contains information you can use to exchange healthcare transactions with University of Pittsburgh Medical Center Health Plan using Stedi.
Use any of the following payer IDs to send transactions to University of Pittsburgh Medical Center Health Plan using Stedi APIs or SFTP. Read the docs
Primary Payer ID
23281
Stedi Payer ID
PKXKN
Payer ID aliases
10288, 23281, 23281MA, 23281MAP, 2803, 7543, U3281, UPMC, UPMCD
Parent group
UPMC Health System Group
Coverage types
Dental, Medical, Vision
Operating states
AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWY
Covered
Not covered

Supported transactions

Use Stedi to exchange the following transactions with University of Pittsburgh Medical Center Health Plan using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Supported

Eligibility checks

(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to University of Pittsburgh Medical Center Health Plan.
Supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to University of Pittsburgh Medical Center Health Plan to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Supported

Real-time claim status

(276/277)
Check on the status of a claim previously submitted to University of Pittsburgh Medical Center Health Plan in real-time by sending a claim status check (276/277).
Supported

Professional claims

(837P)
Submit professional claims to University of Pittsburgh Medical Center Health Plan and receive 277 claim acknowledgments asynchronously.
Supported

Institutional claims

(837I)
Submit institutional claims to University of Pittsburgh Medical Center Health Plan and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from University of Pittsburgh Medical Center Health Plan to review full payment details.
Supported

Dental claims

(837D)
Submit dental claims to University of Pittsburgh Medical Center Health Plan and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to University of Pittsburgh Medical Center Health Plan.
Get started
Use Stedi's APIs to get fast and reliable connectivity to University of Pittsburgh Medical Center Health Plan and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and University of Pittsburgh Medical Center Health Plan today.
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Other names
Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.
  • UPMC Health Plan
  • UPMC Health Plan (TriState)
  • University of Pittsburgh Medical Center Dental Advantage
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