Keystone Health Plan East Provider Manual

You pick a primary care physician PCP or family doctor to coordinate your care. 208-514-0670 HIPAA Fax Patient Documents.

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This is a managed care program.

Keystone health plan east provider manual. When you purchase a Keystone HMO plan from Independence Blue Cross you may see any doctor or visit any hospital in the Keystone HMO network. To receive the highest level of benefits you can see any Keystone Health Plan East participating provider for the following services. Services that have the same cost-sharing across all tiers include.

Mental HealthSubstance Abuse Magellan Healthcare Inc. Keystone HMO Plans 215 675-6846. Affordable Medicare health and prescription drug plans that meet your needs Medicare.

For those interested in electronic claim filing contact your EDI software vendor or Change Healthcares Provider Support Line at 1-800-845-6592 to arrange transmission. Keystone First Claims Filing GuideKeystone First CHC Claims Filing Instructions 2019 6 The Plan encourages all providers to submit claims electronically. A list of Behavioral Health Providers is located in this Section of the Manual Initial Chiropractic VisitEvaluation.

Keystone ensures to revolve every decision they make. This Provider Manual was created as a guide to assist you and your office staff in providing services to our members your patients. Network providers must utilize their assigned laboratory when outpatient laboratory studies are required for their Keystone First members.

Provider Manual 2 Foreword Welcome to Keystone First VIP Choice. Provider Manual and Forms. The only exception to this rule is STAT laboratory services.

Health plans comparison chart Keystone HMO plans Keystone HMO Proactive plans Personal Choice PPO plans Personal Choice EPO plans Personal Choice EPO Reserve plan Personal Choice EPO Catastrophic plan. CMS-1500 claims submission. Fri 8 am.

Learn about our program developed to assist your practice in engaging and managing the healthcare needs of chronically ill Keystone First members. Keystone Health Plan East HMO 11 Summary of Benefits Keystone Health Plan East is a Health Maintenance Organization HMO. Yes all physicians hospitals and ancillary providers from the Keystone Health Plan East HMO network are assigned a tier.

The CMC team made up of physicians and nurses evaluates the proposed plan of care. Non-participating provider emergency services payment guidance PDF Opens a new window. 21 N Fisher Park Way Eagle ID 83616.

Keystone First expects that primary care and specialty care physicians will continue to follow. Provider Services 1-800-521-6007 Email for providers only Contact account executive PDF Contact dental account executive PDF. Provider Change Form - Providers - Keystone First Author.

Providers use the forms below to work with Keystone First Community HealthChoices. Nurse on call 24 hours a day 1-800-521-6007. Customer Service and Precertification 24 hours a day 7 days a week.

Download the 2020 Provider Manual PDF Opens a new window. SPINAL MANIPULATIONS 20 visits per calendar year 40 Copayment No deductible 2 50 after deductible THERAPY SERVICES Cardiac Rehabilitation 36 visits per calendar year 40 Copayment No deductible 50 after. Claims project submission form XLS Critical incident report PDF DHS MA-112 newborn form PDF Diaper and incontinence supply prescription form PDF.

Providers can use this Keystone First VIP Choice Provider Manual as a reference pertaining to medical services for members of Keystone First VIP Choice. Provider Manual and Forms. 2020 Keystone First Provider Manual updates PDF Opens a new window.

Discharge planning guide PDF Opens a new window. Coverage is available when your care is provided or referred by a Keystone primary care physician PCP. Healthy Families Safe Communities.

Affordable Health Insurance plans available from Keystone Health Plan East. Keystone Health Plan East Keystone is committed to bringing you an innovative cost-effective health benefits solution that will enhance the health and well-being of you and your families. For Keystone Health Plan East Members with Caring Foundation benefits 24 hours a day 7 days a week.

Your Keystone PCP may also refer you to other Keystone providers for care if needed. Download the provider manual PDF Forms. Laboratory services that require completion and reporting of results within 4 hours of receipt of the.

STAT laboratory services are defined as. Keystone First Provider Network Management 200 Stevens Drive Philadelphia PA 19113 Fax 215-937-5343 Coverage by Vista Health Plan an independent licensee of the Blue Cross Blue Shield Association. Your PCP will treat you for general health needs and.

Coverage is available when your care is provided by a Keystone Primary Care Physician. Keystone Health Plan East C3-F3 Summary of Benefits Keystone Health Plan East is a Health Maintenance Organization HMO. Keystone Health Plan East Bene ts that require preauthorization Your primary care physician or provider contacts the Care Management and Coordination CMC team and provides information to support the request for services.

Medical coverage from Keystone provides you with access to a large regional network of providers. With a Keystone HMO plan from Independence Blue Cross you can see any doctor or visit any hospital in the Keystone Health Plan East network. Your Keystone Primary Care Physician may also refer you to other Keystone providers for care if needed.

The need for out-of-plan services arises the Network Provider should contact the Utilization. However certain services have the same cost-sharing for all benefit tier levels and therefore are not affected by the provider tier. This is a managed care program.

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