Join our network
Keystone First knows the importance of establishing and maintaining relationships with area physicians, hospitals, and health care providers. Through our partnership with participating providers like you, we aim to give our members the quality health care they deserve.
Are you a non-participating provider?
To comply with provisions of the Affordable Care Act (ACA) regarding enrollment and screening of providers (Code of Federal Regulations: 42CFR, §455.410), effective December 31, 2013, all providers MUST be enrolled in the Pennsylvania State Medicaid program before a payment of a Medicaid claim can be made. This applies to non-participating, out-of-state providers as well.
The following page is dedicated to those who are interesting in becoming a Keystone First network provider. Please review the below information to see how you can become part of the Keystone First provider network.
Note: New provider groups/solo practitioners must sign a contract with Keystone First in order to be credentialed and participate in our network. We only credential contracted/participating providers. If you are joining an existing group that has a contract and is participating with Keystone First, you do not need a separate contract. Please skip to the Credentialing section of this web page for information on how to begin the credentialing process.*
- To begin the contracting process you must complete the contracting application (PDF). Please email it to firstname.lastname@example.org.
- Keystone First will then email you a contract with instructions for signing and return.
- Once you receive a signed contract you can begin the credentialing process for practitioners in your practice.
- Please contact the Keystone First contracting department at 1-866-546-7972 if you have questions.
Keystone First is not currently accepting groups or solo practitioners in the following specialties:
- ASO (AIDS service organizations)
- Ambulance — Closed with the exception to providers that can provide transport for members with Bariatric needs
- Chiropractors — Currently accepting applications in Chester and Montgomery Counties only.
- Durable medical equipment (DME)
- Home health
- Hospice — Closed with the exception to providers that have "free standing" hospice location facilities
- IV home infusion
- Laboratory services
- PPECC (pediatric extended care)
- Skilled nursing facilities
*For behavioral health services, please contact your county service provider, listed below:
|County||Service provider||Phone number|
|Bucks||Magellan Behavioral Health||1-877-769-9784|
|Chester||Community Care Behavioral Health||1-866-622-4228|
|Delaware||Magellan Behavioral Health||1-888-207-2911|
|Montgomery||Magellan Behavioral Health||1-877-769-9782|
Keystone First maintains and adheres to all applicable state and federal standards and regulations, Department of Human Services (DHS) requirements, and accreditation requirements governing credentialing and re-credentialing functions. Call 1-866-546-7972 for more information.
The following types of practitioners require credentialing and re-credentialing:
- Allied health providers (physical therapists, occupational therapists, speech therapists)
- Certified nurse widwife
- Certified registered nurse practitioner
- Oral surgeon
- Physicians (DOs and MDs)
- Registered dietician