Keystone First VIP Choice understands how important it is to form and maintain outstanding relationships with our health care providers. Together, we will strive to accomplish our mission—to improve the quality and accessibility of care to our members.

Our participating providers can use this section of our site to access frequently needed resources, including:

• 275 claims attachment transaction instructions
• Account Executive contact information (PDF)
• Appropriate usage of claims modifiers 25 and 59 (PDF)
• Preventive Services Quick Reference Guide (PDF)
• Care for Older Adults (COA) Form (PDF)
• Claim inquiry form (PDF)
• Clinical resources
• CMS Five-Star Quality Rating System (PDF)
• Common Errors for Claims Submissions (PDF)
• Community HealthChoices (CHC)
• Credentialing
• Dental Reference Guide (PDF)
• Grievances and appeals
• Marketing activities and compliance
• Medicare Medication Adherence Incentive Program (PDF)
• NaviNet User Guide (PDF)
• Plan Comparison (PDF)
• Prior authorization
• Prior Authorization Lookup Tool
• Prior authorization - behavioral health
• Provider manual (PDF)
• Provider Reference Guide (PDF)
• Quality resources
• Reimbursement Policies
• Service area map (PDF)
• Waiver of liability form for non-participating provider appeals (PDF)
  • Payer ID - 77741
• Paper claims submission:
      Keystone First VIP Choice
      Claims Processing Department
      P.O. Box 7143
      London, KY 40742-7143

Check back frequently, since we update this section to include the latest information for our providers. Our participating providers can also call Keystone First VIP Choice Provider Services at 1-800-521-6007.

If you are not yet a participating provider, and you would like more information on the benefits of partnering with us, contact Provider Services at 1-800-521-6007.

Y0093_WEB_318377

Accessing your data on other mobile apps

You have the right to view your health information from Keystone First VIP Choice through websites and mobile apps that are not under Keystone First VIP Choice's control.

Questions

If you don't see what you're looking for, or you need additional help, call us at 1-800-450-1166 (TTY 711), Monday through Friday, 8 a.m. – 8 p.m., from April 1 to September 30; or seven days a week, 8 a.m. – 8 p.m., from October 1 to March 31.

Y0093_001_243582929