Referral Information

Contractual Arrangements
· AACO
· Aetna
· ALS Association
· AmeriChoice
· Amerihealth
· Bravo
· Care Scout
· CIGNA
· Fox Chase Cancer Center
· Gentiva Care Centrix
· Health Net
· Health Partners
· Homelink
· Independence Blue Cross
· Keycare 65
· Keystone Health Plan East
· Keystone Mercy Health Plan
· Medicare/Medicaid
· Personal Choice
· Personal Choice 65
· PHMC
· Theracom
· Tricare
· United Healthcare
· Veterans Administration

Click here for inservice and educational resources available through Keystone Hospice.

Case Managers & Referral Sources:
Contact Keystone's Clinical Intake Office at:

Phone: (215) 836-2440
FAX: (215) 836-2509
E-mail: patient referral@keystonecare.com

Hospice Services
Comprehensive Care At Home
Facility-Based Hospice Support
Keystone House Residential Hospice
HIV/AIDS Care Continuum

Required Information for a Referral
· Patient Information
· Patient Demographics
· Discharge Diagnosis
· Medical History
· Services Requested
· Start of Care Date
· Insurance/Payor Source
· Policy and Authorization Numbers
· Referring Physician
· Contact Information
· Primary Physician
· Contact Information for Follow-up

Service Area
· Philadelphia, Montgomery, Delaware and Bucks Counties

Home and Residential Hospice Care Eligibility Guidelines
· Life-limiting condition of six months
· Patient, family and physician election of palliative care philosophy
· Physician certification and management of the plan of care
· Acceptance of room and board co-payment for residential care

Click here for inservice and educational resources available through Keystone Hospice.

Keystone Hospice • 8765 Stenton Avenue • Wyndmoor, PA 19038
Phone (215) 836-2440 • Administration FAX (215) 836-2448 • Intake & Referral FAX (215) 836-2509
E-mail: info@keystonecare.com• Executive Director: Gail Inderwies, RN, BSN, MBA, CHPN

Keystone Hospice is a not-for-profit, independent agency providing nationally reputable care in
Philadelphia, Montgomery, Delaware, and Bucks counties since 1995.
The official registration and financial information of Keystone Hospice may be obtained from the Pennsylvania
Department of State by calling toll-free within Pennsylvania 1-800-732-0999. Registration does not imply endorsement.

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