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If you aren’t sure whether a provider is preferred, call UMP Customer Service at 1-888-849-3681 (TRS:711) or call the provider directly. For urgent care facilities, make sure you ask whether a provider contracted with Regence is available. These facilities may have a rotating staff that changes frequently.
Note: UMP does not cover most dental services. Search for dental providers through the PEBB Program.
Alert! Because UMP is actively recruiting ABA Therapy agencies and providers, please call 1-888-849-3681 for help finding an ABA Therapy provider. They can also help you find providers who can diagnose autism or confirm an autism diagnosis. If a preferred provider is not available in your area, you may request that a case manager contact you to assist with the next steps in seeking coverage.
When you see a preferred provider...
- You pay less: 15 percent of the allowed amount for most services after you pay your deductible, compared to 40 percent of the allowed amount with participating providers.
- Preventive care services, including immunizations, are covered in full.
- You won't have to file a claim if UMP is your primary coverage.
- The provider won't bill you for more than the plan allowed amount (called balance billing).
Alert! Some providers are considered preferred at one practice location but not another. If you see a provider at an out-of-network location, services will be covered as out-of-network even if he or she is preferred somewhere else. If you see a provider at a new or different location, make sure he or she is a preferred provider there as well.
The plan pays for covered services only when performed by covered provider types working within the scope of their licenses. When a facility charges facility fees, the fees will only be covered when the services you receive are covered services and within the scope of the facility’s license.
All preferred providers are covered provider types. Click on "Covered provider types" below for a full list.
If you see an out-of-network provider that is not a covered provider type, the plan will not pay for any of the services you receive. You will be responsible for all charges. As with all noncovered services, payments you make to a noncovered provider type will not count toward your medical deductible or medical out-of-pocket limit.
|Provider specialty type code||Provider specialty type name|
|ARNP||Advanced Registered Nurse Practitioner|
|CCCA||Cert of Clinical Competence/Audiology|
|CGC||Certified Genetics Counselor|
|CNFA||Certified Nurse First Assist|
|CNM||Certified Nurse Midwife|
|CRNA||Certified Registered Nurse Anesthetist|
|CRNFA||Certified Registered Nurse First Assist|
|DC||Doctor of Chiropractic|
|DDS||Doctor of Dental Surgery|
|DMD||Doctor of Dental Medicine|
|DO||Doctor of Osteopathy|
|DPM||Doctor of Podiatric Medicine|
|EAMP||East Asian Medicine Practitioner|
|LCPC||Licensed Clinical Professional Counselor|
|LCSW||Licensed Clinical Social Worker|
|LICSW||Licensed Independent Clinical Social Worker|
|LMFT||Licensed Marriage/Family Therapist|
|LMHC||Licensed Mental Health Counselor|
|LMT||Licensed Massage Therapist|
|LMSW||Licensed Master Social Worker|
|MD||Doctor of Medicine|
|MSW||Masters in Social Work|
|ND||Doctor of Naturopathy|
|OTR||Registered Occupational Therapist|
|PAC||Physician Assistant Certified|
|PMHNP||Psych. Mental Health Nurse Practitioner|
|PSYD||Doctorate in Psychology|
|RNFA||Registered Nurse First Assist|
|RNSA||Registered Nurse Surgical Assistant|
|RPT||Registered Physical Therapist|
|SLP||Speech Language Pathologist|
A primary care provider (PCP) is a physician, nurse practitioner, or physician assistant who specializes in one of the following:
- Adult medicine
- Family or general practice
- Internal medicine
- Obstetrics, gynecology, or women's health
- Preventive medicine
You are not required to choose a PCP, but doing so may be helpful. A PCP offers and coordinates a range of health care services for you. Think of a PCP as the person who knows the most about your health history and can provide or recommend services based on your needs. To find a PCP in your area, use the provider search.
No, you don’t need a referral to see a specialist for most services. However, you will save money by seeing preferred providers, especially for preventive services. See "Why use preferred providers?" above for details.
UMP Customer Service (for help finding a provider)
Business hours: Monday–Friday 5 a.m. to 8 p.m. and Saturday 8 a.m. to 4:30 p.m. Pacific Time