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  • Upmc Personal Representative Designation Form

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UPMC Health Plan, Inc./UPMC Health Network, Inc./UPMC Health Benefits, Inc. Personal Representative Designation Form Instructions Please fill out this form to appoint a personal representative to.

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UPMC Health Plan accepts claims up to 180 days after the date of service for UPMC Community HealthChoices (Medical Assistance), UPMC for Kids (CHIP), and UPMC for You (Medical Assistance) Members.

Print a Temporary UPMC Member Insurance Card If you do not have your member ID number, call Member Services at 1-888-499-6885. From the homepage, click on order new ID card under Online Services.

Per Illinois probate act 755 ILCS5/1-2.15 defines a personal representative as an administrator, executor, standby guardian, temporary guardian and administrator of a deceased person's estate.

Just click to connect. You can also visit the Contact UPMC page or call 412-647-8762 (UPMC) or 1-800-533-8762 (UPMC). If this is an urgent medical matter, please call 911 or go to the nearest ER for treatment. customer service team.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232