UPMC Credentialing Services for your Independent Practice

As Western Pennsylvania’s only provider-led health insurer, we understand the value of collaboration with network providers and sensitivity to doctor-patient relationships. We are devoted to providing you with a fair and uncomplicated process so that you may focus on what you do best: caring for patients.

So, whether your practice focuses on physical or behavioral health, we would be delighted to collaborate with you.

UPMC Credentialing

This website is intended to give health care professionals — physicians, nurses, and allied health professionals — with information about the credentialing process for hospital privileges at UPMC.

Practitioners who intend to deliver services at UPMC locations must be accredited by each center.

On behalf of the facilities, the UPMC Credentials Verification Office (CVO) examines the applications and gets primary source verification.

Our Specialist will assist you in getting your credentials instantly.

We will review your educational history, career experience, credentials, and registration to practice in the healthcare industry during the credentialing process. Throughout the credentialing process, we will monitor your progress to determine your education, training, credentials, and registration to practice in a health care setting. We will examine all of your documents to ensure that you have been certified by one of the world’s most prominent healthcare providers. As a team, we are devoted to long-term growth. We will help you obtain the services you desire. This is how we show our appreciation to our customers and demonstrate our commitment to providing great customer service.

How to Submit an Application

If you do not presently have privileges at a UPMC site or would wish to obtain privileges at another UPMC facility, you must first complete the UPMC CVO first online application.

Initial Appointment

Initial candidates to one or more UPMC facilities fill out an online application. The Practitioner Portal is used to submit the application and requested papers to the UPMC Credentials Verification Office (CVO). The information and documents supplied are stored in a central data repository managed by the CVO. The applicant’s designated facilities are granted access to the information and documents. The CVO conducts primary source verification and enters the verification information into the data repository, making it available to the facilities where the application has been accepted for processing. The application is processed by the institution in accordance with the facility’s Bylaws, Rules and Regulations, and Policies. Each facility retains responsibility for evaluating the information submitted by the applicant and obtained by the CVO, as well as the following recommendation for membership and granting of privileges.

Reappointment

A System reappointment date is assigned to each physician and other health care practitioner who is currently certified by a UPMC institution or organization. A prefilled reappointment application with the information currently in the central data repository is supplied via the Practitioner Portal five months before to the allocated date for evaluation, completion, and submission to the CVO. The CVO does the required primary source verification. The application and verification information are made available to the facilities and organizations in which the physician or other health care practitioner is a member and has privileges. Each institution retains responsibility for evaluating the material submitted by the applicant and obtained by the CVO, as well as the subsequent recommendation for ongoing membership and privileges.

Privileges

• Practitioners requesting clinical privileges at UPMC can identify all requests for privileges and areas of practice on a single Privilege Request Form. The CVO distributes the completed Privilege Request Form to all facilities where privileges are requested, just as it does with other application materials.

• The generic form for requesting clinical privileges is not intended to take the place of the particular hospital’s jurisdiction over clinical privileges granting. This authority is nonetheless limited by the guidelines imposed by the hospital medical staff bylaws. Each facility retains responsibility for the granting of rights.

• Despite the fact that the request for privileges is designated on a single Privilege Request Form, the privileges granted are facility-specific and may differ from facility to facility depending on the services provided at the facility and the facility-established criteria for the granting of the privilege.

Central Information Repository

The CVO ensures that the data in the central data repository is up to date and accurate. The CVO sends notices of expired documents and makes current documents available to each facility and organisation where the physician or other health care practitioner has membership and privileges. Changes to the data that are reported are stored in the data repository and distributed to the facilities and organizations with which the physician or practitioner is affiliated.

The CVO is in charge of ensuring data security and maintaining data confidentiality. Multiple degrees of protection protect the data repository on a secure network server from unauthorized external and internal access. Access to the data in the repository is contingent on the user’s recognition, authentication of the user’s facility or organisation, and the precise permissions allowed to the user to enter, view, or amend the information.

UPMC Phone Number

Call 412-864-0284 or 1-844-591-5949 to talk with a customer care representative.

UPMC Email Address

If you need any assistance, please contact MyUPMC at help@myupmc.com.

UPMC Enrollment Form

You can enroll yourself by following these guidelines from downloadable form https://www.wpaumc.org/files/benefits/health+care/upmc+enrollment+application.pdf