Claims and Billing

If you need assistance at any time, feel free to contact your account executive (PDF). Also, don't forget to sign up for email alerts to receive our most updated information.

Sign up for email alerts

• Claims filing instructions (PDF)
  Claims processing address:
  Keystone First
  Claim Processing department
  P.O. Box 7115
  London, Kentucky 40742
• June 1, 2020, new and current explanation of benefit (EOB) codes (PDF)
• Supplemental billing information for modifiers 25 and 59 (PDF)
• EDI FAQs
• Electronic claims submission, payment, and remittance advice services
• Eligibility verification guide (PDF)
• False Claims Act information (PDF)
• Fraud, waste, and abuse information
• MA fee schedules
• Member co-pay schedule (PDF)
• Vitamin D Testing ICD Allowable List (PDF)

Third-party liability

Third-party liability (TPL) is when the financial responsibility for all or part of a member's health care expenses rests with an individual entity or program (e.g., Medicare, commercial insurance) other than Keystone First.