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​Billing Information

As a courtesy to our patients, UPMC bills the insurance carrier directly for most services. Co-pays, deposits, and other co-insurance amounts are due at the time the services are provided. Depending on your insurance, you may be responsible for paying the entire charge and any charges for services not covered by your insurance. For a list of services that are not covered, please contact your insurance company.

Any additional patient financial responsibility is due when you receive your medical bill. You may receive more than one bill for services rendered at UPMC. These bills may be from a hospital, physician, or an ambulance service.

If you receive a hospital bill and do not understand the content, or if you believe that the information may be incorrect, please call our Customer Service Department at 412-432-5500 or toll-free 1-800-854-1745. If you would like to request information about a UPMC physician bill, please call 412-442-9600 or toll-free 1-888-647-9600.

Insurance Referrals and Authorizations

Based on your insurance coverage and the medical services provided, an authorization or referral from your insurance carrier may be required.  It is important that you are familiar with your benefits and the extent of your medical coverage. We suggest that you contact your insurance carrier before scheduling a procedure.  Also, please check with the registration clerk or your insurance carrier to find out if a referral or authorization is needed for your procedure

Hospital Based Clinics

UPMC is designated as a hospital-based-clinic. A hospital-based-clinic is a facility similar to a physician’s office. The clinic provides diagnostic, preventive, curative, and rehabilitation services. The services are provided by an employed physician; however, the clinic is owned and operated by the hospital. Some insurance companies view this type of service as an outpatient clinic visit. You may incur a facility charge that may be assigned as patient’s responsibility. This kind of charge may not typically be incurred if the clinic were not considered hospital-based.

The physician’s bill is for professional services or procedures performed by your personal doctor. The hospital bill or the facility bill covers the cost of the operating room and other overhead costs.

Under Centers for Medicare and Medicaid Services (CMS) regulations and insurance industry regulations, UPMC sends bills for both the facility and professional services. The insurance carrier has different requirements based on the contract with the health care provider. Depending on your insurance plan, you may be responsible for paying the entire hospital or facility bill, co-insurance, and/or related co-pay for physician charges. You will receive separate bills from the physician and hospital for both inpatient and outpatient visits.

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For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

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