Keystone Health Plan East
Keystone Health Plan East is a regional health plan. For an ASC, what matters isn't the logo. It's how Keystone Health Plan East pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete Keystone Health Plan East analysis
Tell us where to send it. Our team will prepare an analysis of Keystone Health Plan East covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How Keystone Health Plan East pays
See how Keystone Health Plan East reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
See where Keystone Health Plan East concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Keystone Health Plan East and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Keystone Health Plan East's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking Keystone Health Plan East up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Keystone Health Plan East
- Payer ID
- 95056 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Keystone Health Plan East through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Keystone Health Plan East members are verified before the date of service, through a clearinghouse using payer ID 95056or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Keystone Health Plan East directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Keystone Health Plan East the way it pays.
- What is Keystone Health Plan East's payer ID?
- Keystone Health Plan East's electronic payer ID is 95056. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Keystone Health Plan East through a clearinghouse.
- How do ASCs verify eligibility for Keystone Health Plan East members?
- Eligibility and benefits for Keystone Health Plan East members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 95056) or through the payer's provider portal.
- Does Keystone Health Plan East require prior authorization for ASC procedures?
- Prior-authorization requirements for Keystone Health Plan East are set per plan and per procedure. Confirm whether an authorization is required with Keystone Health Plan East directly before the date of service.
- What type of payer is Keystone Health Plan East?
- Keystone Health Plan East is a regional health plan.
- How does Keystone Health Plan East compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Keystone Health Plan East pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Keystone Health Plan East paying my ASC below market?
- Put your own Keystone Health Plan East contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.