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Keystone First provider portal, phone and payer ID

Keystone First · A AmeriHealth Caritas company

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Updated

TL;DR

Keystone First, a AmeriHealth Caritas subsidiary, is a medicaid mco payer covering roughly 460k members operating in 1 state. Provider phone is 1-800-521-6622. Claims payer ID is 23284. This registry lists 180 days as an initial-claim reference for Keystone First. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims. Electronic claims (837), eligibility (270/271), prior auth (278), and ERA (835) are supported. Use the provider portal for eligibility, claims status, prior authorization, and appeal workflows.

Keystone First provider portal, phone and payer ID quick facts

Provider portalhttps://www.keystonefirstpa.com/provider
Provider phone1-800-521-6622
Claims payer ID23284
Eligibility payer ID23284
ERA payer ID23284
Timely filing180 days (verify applicability)
Prior auth routeX12 278 plus provider portal
Last reviewed2026-04-23
  • This registry has not established a payer-specific appeal ladder for Keystone First. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.

Keystone First at a glance

Legal nameKeystone First
Also known asKeystone First PA Medicaid, Vista Health Plan
CategoryMedicaid MCO
Parent organizationAmeriHealth Caritas
Claims payer ID23284
Eligibility (270/271) payer ID23284
ERA (835) payer ID23284
NAIC company codeNot established in this registry
States coveredPennsylvania
Members covered~460k members
Provider portalhttps://www.keystonefirstpa.com/provider
Provider phone1-800-521-6622

Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.

Timely filing & appeals for Keystone First

This registry lists 180 days as an initial-claim reference for Keystone First. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.

Submission typeWindow
Initial claim reference180 days (verify applicability)
Out-of-network initial claimVerify the member's plan and applicable out-of-network rules
Secondary / coordination of benefitsVerify the allowed window and start event; a primary EOB does not automatically restart filing
Corrected claimVerify correction instructions; do not substitute an appeal deadline
Reconsideration / appealUse the applicable denial or decision notice and the process below

This registry has not established a payer-specific appeal ladder for Keystone First. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.

Source: Keystone First provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.

Prior authorization with Keystone First

Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.

CMS-0057-F decision-timeframe requirements and exclusions

Keystone First accepts X12 278 prior-authorization transactions electronically. The procedures most commonly subject to prior authorization include advanced imaging, inpatient admissions, specialty pharmacy, and certain outpatient surgical procedures. Use the payer's authorization tool below to confirm requirements per CPT before scheduling a service.

Keystone First maintains a live prior-authorization code lookup tool that supersedes any cached list. Use the provider portal or the policy documents below to confirm the current PA list before rendering a service.

Top denial reasons for Keystone First

Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Keystone First volume. Until then, see the broader CARC reference for industry-wide remediation guides.

Electronic claims, eligibility & ERA

TransactionSupportedPayer ID
837P / 837I claimsYes23284
270 / 271 eligibilityYes23284
278 prior authorizationYesVerify X12 278 routing separately
835 ERAYes23284

Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.

State coverage

Keystone First operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.

QuickIntell coverage for Keystone First

  • QuickRCM

    End-to-end claim lifecycle automation tuned to Keystone First's edits and adjudication patterns.

  • QuickAuth

    Automated prior-authorization submissions and status checks for Keystone First services that require PA.

  • QuickERA

    Automated 835 ERA posting from Keystone First with payment reconciliation and denial routing.

Frequently asked questions about Keystone First

Where is the Keystone First provider portal?

The Keystone First provider portal is available at https://www.keystonefirstpa.com/provider. Use it for eligibility checks, claim status, prior authorization workflows, appeals, and payer-specific routing updates. QuickIntell links to the payer's provider-facing portal as a reference and is not the official payer portal.

What is the timely filing limit for Keystone First?

This registry lists 180 days as an initial-claim reference for Keystone First. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.

What is the Keystone First payer ID?

The registry lists claims payer ID 23284 for Keystone First. Eligibility (270/271): 23284. ERA (835): 23284. Do not substitute a claims ID for an unverified transaction ID. Confirm the member ID card, product and clearinghouse payer list before submitting.

Does Keystone First accept electronic claims?

Yes — Keystone First accepts ANSI X12 837P and 837I electronic claims through standard clearinghouses. Real-time eligibility (270/271) is supported and X12 278 prior authorization is supported.

How do I appeal a Keystone First denial?

This registry has not established a payer-specific appeal ladder for Keystone First. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.

How long do Keystone First prior authorization approvals take?

Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.

What is the Keystone First provider phone number?

This registry lists 1-800-521-6622 as a provider contact for Keystone First. Confirm the service scope and the number on the member ID card; claim, eligibility and authorization inquiries may use different teams. Have the member ID, date of service and tax ID ready. The provider portal is https://www.keystonefirstpa.com/provider.

Automate workflows around Keystone First requirements

Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.

Disclaimer

This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Keystone First's current published documents before submission. CPT® is a registered trademark of the American Medical Association.