FAQs Document - October 31, 2016
UPMC Health Plan Contract FAQs
What is the agreement with UPMC?
· Sharon Regional has signed a new contract with UPMC Health Plan that includes many Commercial Plans, Medicare, and Medicaid.
· The new contract provides UPMC Health Plan members in-network access to the Sharon Regional services, whether elective or emergency.
· This agreement opens access to all Sharon Regional Health System programs and services AND includes Sharon Regional Medical Group, Sharon Regional’s provider network that employs more than 50 primary care physicians and specialists on the medical staff at Sharon Regional Health System.
Does this affect independent physicians on the Sharon Regional medical staff?
· Many of the physicians on the current hospital medical staff have been credentialed with UPMC Health Plan. This provides their patients with the choice to elect to receive their health care services at Sharon Regional.
· For those physicians who are not currently credentialed with UPMC Health Plan, they can submit the necessary forms to UPMC Health Plan to become a provider.
When is the agreement effective?
· The new contract is effective immediately.
How does this benefit Sharon Regional employees?
· Any Sharon Regional Health System employee and/or family member enrolled in UPMC Health Plan now has in-network access to Sharon Regional services.
What are the benefits to patients?
· Individuals and families with UPMC Health Plan have access to a wider array of advanced health services and skilled physicians here in our local area. We believe that offering choices in the market and increasing access for many patients who seek healthcare programs and services is important.
· As the region’s largest employer and largest health care provider, our number one commitment is to continue to provide access and choice for quality, affordable services for our patients and our community members.
Will other payor contracts remain the same?
· Yes. Sharon Regional Health System will continue to contract with most major health insurers such as Aetna, Cigna, Medicare, Tricare, Coventry, Medical Mutual and United. This includes our current status as a preferred provider for Highmark Blue Cross Blue Shield plans including: Connect Blue, Community Blue, Medicare HMO and Select Blue.
Who do I contact with questions?
· For questions regarding insurance eligibility or options or about enrolling in an insurance plan available in the Marketplace, visit www.SharonRegionalChoice.com or call 724-983-5581.
· Current UPMC Health Plan members with questions can contact Member Services via the phone number on the back of their member card.
· Members are encouraged to confirm their individual plan’s network coverage.
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