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Quality Resources

  • Adult Body Mass Index (BMI) Assessment Claims Coding Chart PDF
  • Care for the Older Adults (COA) Claims Coding Chart PDF
  • Care for Older Adults (COA) Form PDF
  • CMS Five-Star Quality Rating System and Our Network Providers PDF
  • Consumer Assessment of Healthcare Providers and Systems (CAHPS®) and Health Outcomes Survey (HOS) Information PDF
  • Diabetes Coding for HEDIS PDF
  • HEDIS Incentive Program PDF
  • Incentive Program - The PerformPlus Stars Total Cost of Care Program PDF
  • Medicare Risk Adjustment Overview and Documentation Guidance PDF
  • Transitional Care Management With Medication Reconciliation Post-Discharge Notice PDF
  • Urinary Incontinence Notice PDF
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Copyright © 2013-2025 KEYSTONE FIRST VIP CHOICE. All rights reserved.

Last Update: Tuesday, October 1, 2024 3:26:26 PM

Coverage by Vista Health Plan, Inc. Independent Licensee of the Blue Cross and Blue Shield Association.

This site contains links to other internet sites. Keystone First VIP Choice (HMO SNP) is not responsible for the content of these sites. Please see Terms of Use, Privacy Notice, Third-Party Data Privacy and Educational Materials, and Potential for Contract Termination.

Keystone First VIP Choice is an HMO-SNP plan with a Medicare contract and a contract with the Pennsylvania Medicaid program. Enrollment in Keystone First VIP Choice depends on contract renewal. This information is not a complete description of benefits. Call 1-800-450-1166 (TTY 711), Monday through Friday, 8 a.m. – 8 p.m., from April 1 to September 30; or seven days a week, 8 a.m. – 8 p.m., from October 1 to March 31 for more information.

Out-of-network/non-contracted providers are under no obligation to treat Keystone First VIP Choice members, except in emergency situations. Please call our Member Services number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. You must continue to pay your Medicare Part B premiums, unless otherwise covered by your Pennsylvania Medicaid benefits.

Every year, Medicare evaluates plans based on a 5-star rating system.

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The Pennsylvania Department of Human Services must make sure that everyone who is receiving Medical Assistance is still eligible by reviewing each person's information.

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Keystone First VIP Choice does not operate, control or endorse in any way any information, products or services available from other Internet web sites. Keystone First VIP Choice provides these links only for the convenience of users in locating information and services that may be of interest to them.

While Keystone First VIP Choice does not disclose your personally identifiable information to the owners or operators of any linked sites, Keystone First VIP Choice cannot control the security or privacy of any information that you may choose to voluntarily provide while visiting any linked sites.

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Any health-related information contained on any linked website is intended to provide general educational information. It is not intended and should not be used as a substitute for professional medical advice. You should consult with your physician with any questions you may have regarding a medical condition.

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You are leaving the Keystone First VIP Choice (HMO SNP) website

If you are using pop-up blocking software, you may not be able to view this web site. Please disable your pop-up blocker before selecting "I Agree" below.

By choosing to continue to the linked site, you will be taken to a site that is not the responsibility of, or under the control of, Keystone First VIP Choice.

Keystone First VIP Choice does not operate, control or endorse in any way any information, products or services available from other Internet web sites. Keystone First VIP Choice provides these links only for the convenience of users in locating information and services that may be of interest to them.

While Keystone First VIP Choice does not disclose your personally identifiable information to the owners or operators of any linked sites, Keystone First VIP Choice cannot control the security or privacy of any information that you may choose to voluntarily provide while visiting any linked sites.

Keystone First VIP Choice cannot guarantee or warrant that files available for downloading from linked sites will be free of infection or viruses, worms, Trojan horses or other code or "mal-ware" that manifests contaminating or destructive properties.

Any health-related information contained on any linked website is intended to provide general educational information. It is not intended and should not be used as a substitute for professional medical advice. You should consult with your physician with any questions you may have regarding a medical condition.

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