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Paper Credentialing

If you are not registered with the Council for Affordable Quality Healthcare (CAQH)* and would prefer to join the Keystone First CHC provider network via our paper process, complete and return the documents linked below. If you have any questions, please call 1-800-642-3510, option 1.

*CAQH credentialing does not apply to HCBS and LTSS providers. HCBS and LTSS providers should complete our paper application process.


HCBS and LTSS providers

HCBS and LTSS provider requests for a contract can be sent to Please include a copy of your W-9, counties that you cover, and services that you provide. A completed contract is required in order to start the credentialing process.

Physical health practitioners

Organizational providers

Completing and/or submitting the Keystone First CHC credentialing application does not guarantee participation in the Keystone First CHC provider network.

Note: If you are joining an existing Keystone First CHC participating group or health care facility and you would like to become a participating provider, please use the credentialing application (Pennsylvania Standard Application) (PDF).

Documents and information