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UPMC Health Plan
Behavioral Health Services Member Services
1-888-251-0083
1-877-877-3580 (TTY)

Monday - Friday, 8AM - 5PM
In urgent or emergency situations,
staff is available 24 hours a day,
7 days a week.

External Appeals for Utilization Management Decisions

Under specific circumstances determined by Pennsylvania law, a member can request an external review of a medical necessity decision (denial) through a process managed by the Pennsylvania Department of Health. To initiate the external review, the member should contact the UPMC Health Plan Member Services at 1-888-876-2756.

The following contact information is also available, representing agencies responsible for monitoring health plan compliance with complaint and grievance procedures:

Pennsylvania Department of Health
Bureau of Managed Care
Health and Welfare Building, Room 912
7th and Forster Streets
Harrisburg, PA 17120
1-888-466-2787

For speech and/or hearing impaired persons, please contact the Pennsylvania AT&T Relay Services at 800-654-5984.

The Bureau of Consumer Services in Pennsylvania Insurance Department
1321 Strawberry Square
Harrisburg, PA 17120
1-877-881-6388

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