Resources

Communications

• Communicating with third-party vendors (PDF)
• Provider Notifications
• Provider Newsletters
• Pennsylvania Department of Human Services (DHS) Medical Assistance Bulletins
• HIPAA
• Keystone First – CHIP vaccine/immunization procedure codes

Manuals, guides, and training 

• Provider Manual
• Provider reference guide (PDF)
• Provider training and education

Programs

• Let Us Know
• Bright Start
• PerformPlus® Total Cost of Care for Primary Care Providers (PDF)
• Special Health Programs — Care Management

Clinical resources

• Clinical policies
• Clinical practice guidelines (PDF)
• InterQual criteria
• Evolent outpatient radiology
• Reimbursement policies
• Services Requiring Prior Authorization
• American Academy of Pediatrics (AAP) Recommendations for Pediatric Preventive Health Care (PDF)
• Immunization and catch-up schedule (PDF)
• Medical record standards

Initiatives

• Cultural responsiveness
• Mandatory Reporting Requirements
• Smile Starter (PDF)

Enrollee information

• Rights and responsibilities (PDF)
• Keystone First – CHIP Benefits at a Glance (PDF) 
• Domestic violence resources (PDF)