- Fax: 1 (215) 937-5018
- Prior Authorization Retro Fax: 1 (215) 937-737
- DME Fax: 1 (215) 937-5383
- OB Request Fax: 1 (844) 688-2973
- Phone: 1 (800) 588-6767
Keystone First (Rx) Prior Authorization Form
A Keystone First Prior Authorization Form allows physicians to secure coverage for a non-preferred medication on behalf of their patients.
Updated October 31, 2024
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