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  • Health Reimbursement Arrangement Claim Form - Upmc Health Plan

Get Health Reimbursement Arrangement Claim Form - Upmc Health Plan

HEALTH REIMBURSEMENT ARRANGEMENT CLAIM FORM Mail to UPMC Health Plan PO Box 2999 Pittsburgh PA 15230 PLAN AND EMPLOYEE INFORMATION LAST NAME E-MAIL PLAN YEAR FIRST NAME DAYTIME PHONE EMPLOYER NAME Phone 1-866-328-8762 No. of pages MEMBER ID NUMBER DATE OF BIRTH EMP ID Note Reimbursements will be sent to the address on file with UPMC.

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Founded in relationship-centered care, the patient and family are partners with the health care team on the journey toward the patient's best possible state of health. UPMC Care means that patients and families are at the center of everyone's work.

For questions about this process, contact UPMC Health Plan Web Services at 1-800-937-0438 from 8 a.m. to 4:30 p.m., Monday through Friday.

All claims must be filed within one year of the date of service.

You may also ask for a coverage determination, redetermination, or appeal by calling our Member Services Department at 1-800-606-8648 from 8 a.m. to 8 p.m., seven days a week. * TTY/TDD users should call 1-866-407-8762.

Get your EOBs electronically with the UPMC Health Plan app and MyHealth OnLine. We will email you a link so you can see your EOBs electronically. Changing your preferences will replace getting your EOBs in the mail.

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.

UPMC Health Plan accepts claims up to 180 days after the date of service for UPMC Community HealthChoices (Medical Assistance) Participants.

Coordination of Benefits (COBs) In addition to your UPMC Health Plan insurance, you may have additional health insurance coverage through your spouse, another employer, or a government-sponsored program such as Medicare or Medical Assistance.

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© Copyright 1997-2025
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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