Kaiser provider Find additional providers in the Northwest region with Kaiser Permanente's comprehensive directory for Oregon and Washington. Some Kaiser Permanente services are provided by affiliates, which may include physicians, hospitals, and pharmacies. org using your secure User ID and password, the region in which you are a Kaiser Permanente member will automatically display. All fields are required unless marked as optional. Contact us or view the appropriate manual for clinical locations and their contact information. g. KP Medi-Cal Medical Director Dr. Find a Doctor Search for doctors, medical centers, pharmacies, and walk-in clinics. to 5:00 p. For healthcare providers seeking to join Kaiser Permanente’s network, understanding the credentialing process is essential to establishing a successful partnership with one of the nation’s largest integrated health systems. KP Online-Affiliate requires a minimum screen resolution of 1024x768 pixels. Pacific Time Regional Credentialing fax lines (toll free) Initial Credentialing 1-866-214-7584 Recredentialing 1-866-232-0147 Expirables 1-866-455-1050 Regional Credentialing Email Addresses: Initial Credentialing: Regional-Credentialing-Online-Apps@kp. Affiliated providers belong to a local medical group with whom we have contracted to provide care to Kaiser Permanente members. org/travel to find out how to get care away from home. Please fax completed form with supporting documentation to 877-800-5456. Aug 8, 2019 · What is Affiliate Link? Affiliate Link (AFL) is a tool that provides web access to patient information within Kaiser Permanente’s HealthConnect (KPHC) electronic medical record system. Find hospitals, urgent care centers, pharmacies, and other locations near you. This directory includes providers Documentation can be attached to support the services the pre-authorization will include. Learn about what we do and how you can become a part of it. 5 days ago · Sapphire365 helps users find healthcare providers and services under Kaiser Permanente plans, including Senior Advantage Choice PPO. org using your secure User ID and password, the region in which you are a Kaiser Kaiser Permanente reserves the exclusive right to modify, revoke, suspend or change authorization and medical necessity review requirements, at Kaiser Permanente's sole discretion. Sections 1 and 2: Kaiser Permanente Medical Care Program Sign on Kaiser Permanente affiliate providers and medical office staff: Please sign on to gain access to secure features. org/ga for more information, and to access the Provider Manual. : Kaiser Permanente current and previous private/group practices professional affiliations (hospital staff memberships and facility A practitioner must be credentialed with Kaiser Permanente before caring for our members. Get to know our doctors and choose one who’s right for you. C. To begin, select the area from the pull-down menu that best describes the geographic region in which you may receive care from Kaiser Permanente. Provider services consultants act as a partner and liaison to offer a variety of resources, information, and tools across our contracted network. Provider contracting Provider contracting ensures that Kaiser Permanente purchases health care services in the most prudent, cost-effective manner possible. Choosing Child Care | Kaiser Permanente What is child care? Child care is short-term care by someone other than a parent. With two tiers, you can choose your provider & where to get care, any time you need it. Colorado | Kaiser Permanente Kaiser Permanente is Colorado's largest nonprofit health care provider, proudly working to improve the lives and health of the state's residents for 49 years. org This application is only for organizations providing certain services, such as ambulatory surgery centers, durable medical equipment, home health care, hospitals, skilled nursing facilities and other facilities. ), please contact the EDI Support Team at EDISupport@kp. m. Apr 7, 2025 · Provider credentialing is a critical process in the healthcare industry that ensures patients receive care from qualified medical professionals. For alternative EDI solution options, please see our Claims page section , which includes the different EDI Clearinghouses Kaiser Permanente connects with and special solutions available from Office Ally for FREE bulk and individual claim If you have completed the KP Online-Affiliate registration process, received your user ID which is your National User Identification Number (NUID), and are unable to sign on, please call 844-563-4357 (toll free). Feb 15, 2022 · Questions about EDI, ERA or EFT? For inquiries about EDI, ERA or EFT enrollment, or any issues related to EDI submissions (claim rejection, missing claims, etc. To request the pertinent page or pages of the provider directory as a printed document, please contact member services at (855) 364-3184. These providers care for only your child or children. From 24/7 advice and phone appointments to urgent and emergency care, you have many convenient ways to get the medical and mental health care you need in How to find care in Maryland, Virginia, and Washington, D. The Provider Contracting and Relations Department welcomes you as a valued contracted provider with Kaiser Permanente. org Member Assistance Other Languages Choice PPO is fully underwritten by Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan (KFHP), Inc. View information about how Kaiser Permanente is collaborating with local counties, entities and providers to ensure Medi-Cal members receive services and support including care management and additional services. org As your partner in health, we’re here to help you thrive. Having Added Choice makes it easy to find doctors and facilities for your care. Online provider tools Welcome to our secure features for Kaiser Permanente providers and medical office staff. Sentara Health Plans and Kaiser Permanente are collaborating in Northern Virginia to offer you expanded access to health care services. This application is only for providers, such as physicians, physical, occupational and speech therapists and other professionals. Key elements considered in contract negotiations include: Reimbursement Quality of care Utilization Compatibility in goals and values Your contract manager is available to help you: Understand contract provisions Resolve contract disputes Announcements Enroll & Register for KP Online Affiliate access to update your data through the Provider Data Attestation Portal which is coming soon. To report inaccurate provider directory information, please click on Welcome to our secure features for Kaiser Permanente providers and medical office staff. SECTION 4 KEY CONTACTS Each Kaiser Permanente Region handles Claims, Payments, Services with some slight variation. Please see the contacts for each region. Care Chat Get care from Kaiser Permanente clinicians via secure online chat. Kaiser Permanente Southern California builds healthier communities and expands access to health care through our work with hundreds of community partners. Search for primary care doctors and specialists in Southern California. If you can't view Search for primary care doctors and specialists in Northern California. Choosing a Health Care Provider | Kaiser Permanente Choosing a doctor or other health care provider is very important. Visit kp. org to learn how we customize care and coverage just for you. If you have any questions about the pre-authorization request form, the pre-authorization process, or what services require pre-authorization, please call us at the phone number below. Members enrolled in Kaiser Foundation Health Plan (KFHP) Marketplace plans have access to the same provider networks as members enrolled in all other KFHP plans. Online Affiliate is enabled with a robust set of features that can help simplify the process of obtaining KP member information and performing claim reconciliation. Staying healthy is easier with the right support. Sign on Kaiser Permanente affiliate providers and medical office staff: Please sign on to gain access to secure features. No account? Register now. Read on to learn how to register, login, and Online provider tools Welcome to our secure features for Kaiser Permanente providers and medical office staff. Provider Application for Participation Instructions This is a PRACTITIONER APPLICATION for consideration into Kaiser Permanente’s network of providers. org or the Kaiser Permanente mobile app? Here are some tips you can try to solve the problem. To access your Practitioner Home Page (PHP), enter your email address and password below (the password is case sensitive). Sign on to our secure provider tools to access authorizations and referral guidelines. Note: Depending on the date you start the search, you may also see Past eligibility Search for primary care doctors and specialists in Georgia. Non-contracted providers can contact the Provider Assistance Unit at 1-888-767-4670. Section 6: Provider Rights and Responsibilities As a contracted Provider for Kaiser Permanente, you are responsible for understanding and complying with terms of your Agreement and this Provider Manual. From 24/7 advice and phone appointments to urgent and emergency care, you have many convenient ways to get the medical and mental health care you need. Welcome from Kaiser Permanente It is our pleasure to welcome you as a contracted provider (Provider) participating under HMO plans offered by the Kaiser Permanente Medical Care Program Affiliated Payors. Call 24/7 for advice and appointments. Provider Information Provider Manuals The content of the Northern California Provider Manuals offers providers detailed operational guidance and requirements. See doctors in your network, choose a doctor, and use the cost estimator. Recredentialing takes place every two years. Appeals criteria and time frames for resolution are identical for all members requesting an expedited appeal. Providers are invited and encouraged to request access to KP’s Online Affiliate tool. Thank you for participating as a contracted provider with Kaiser Permanente (KP). Browser issues Mobile app issues Still need technical help? Information on how to submit changes or updates to your provider information so Kaiser Permanente can maintain an accurate provider directory. Sections 1 and 2: Kaiser Permanente Medical Care Program Kaiser Permanente affiliate providers and medical office staff: Please sign on to gain access to secure features. Kaiser Permanente NW Regional Referral Center: 503-813-4560 or 1 New Changes to Provider Portal You may be aware we have decommissioned the provider portal Affiliate Provider Connect (APC). With two options, you can choose your provider and where to get care, any time you need it. About our physicians Information about our affiliated community providers may vary by location. If, at any time, you have a question or concern about the information in this Manual, you can reach our National Provider Contracting Department by calling 510‐268‐5448. Box 6927 Columbia, SC 29260 1-866-653-0338 KPMA-100050-03-2023 Staying healthy is easier with the right support. Provider Dispute Resolution Process KP actively encourages our contracted Providers to utilize MSCC staff to resolve billing and payment issues. Kaiser Permanente provider portal offers secure access to tools and resources for affiliate providers and medical office staff. We would like to show you a description here but the site won’t allow us. or any other or related Kaiser Permanente entity to enter into a new contractual obligation nor renew an earlier contract. This site will give you helpful information about our credentialing and privileging processes and will help you navigate through our online applications. Search for primary care doctors and specialists in Hawaii. kp. Kaiser Permanente of the Mid-Atlantic States has 1,800+ specially selected, board-certified physicians throughout the region, and they’re recognized by our communities for the quality of care they provide. There are two basic types of child care: individual and group. Through this relationship, Sentara Health Plans members will receive quality health care at any conveniently located Kaiser Permanente medical centers. O. Throughout Los Angeles, Kern, Orange, San Diego, San Bernardino, Riverside, and Ventura Counties, our physicians and care teams WELCOME Welcome to the Regional Credentialing Web Site for Kaiser Permanente in Northern California, which includes Kaiser Foundation Health Plan, Inc. kaiserpermanente. If there isn’t a Kaiser Permanente location near you, visit kp. Browse our online doctor bios for details on education, languages spoken, and more. 9 million Kaiser Permanente members throughout Southern California. Your Doctors, Your Care – Kaiser Permanente of Northern California Provider Payment Dispute Resolution Submission Form Provider Tax Identification Number: Provider Group Name & Address: Provider Contact Name & Phone Number: Provider E-mail Address: Technical support Having technical issues with kp. Pre-authorization requests must be submitted by a healthcare provider. 6. Your Doctors, Your Care – Kaiser Permanente of Northern California Provider Payment Dispute Resolution Submission Form Provider Tax Identification Number: Provider Group Name & Address: Provider Contact Name & Phone Number: Provider E-mail Address: This gives each member the full benefit of our medical staff's combined expertise. Nov 14, 2025 · Return to KP. Please refer to each of the sections below for more information. STEP 3 The system will require verification then display the Members current eligibility in our system. Welcome To Kaiser Permanente This section of the Manual was created to help guide you and your staff in understanding your rights and responsibilities as our contracting Provider. Then choose the right doctor for you when your coverage starts. This directory provides a list of Kaiser Permanente network providers. Welcome Providers! Please select a geographic area so that we can provide you with information customized for that region. A secure platform for Kaiser Permanente affiliates to access claim statuses and other relevant details. Kaiser Permanente affiliate providers and medical office staff: Please sign on to gain access to secure features. We are committed to fully supporting you, your medical support staff, and our members. Contact us Regional Credentialing messaging line 1-510-625-5608, Monday through Friday, 8 a. To view information for Important disclaimer: Submission of an application does not constitute any obligation on the part of Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. How do I search for a doctor, hospital, or other medical facility? To begin, select the area from the pull-down menu that best describes the geographic region in which you may receive care from Kaiser Permanente. Claire Horton, VP, National Medicaid Medical Director For questions about KP’s Please see htp://providers. Kaiser Permanente reserves the exclusive right to modify, revoke, suspend or change authorization and medical necessity review requirements, at Kaiser Permanente's sole discretion. , the Mid-Atlantic Permanente Medical Group, P. Also search by specialties. org Authorizations policies Download our authorization policies* to learn more about our utilization management and authorizations process, including: the role of the Provider Service Center, our centralized authorization and referral department referral policies and procedures hospital and facility admissions case management denials and appeals *This link will open a new window. 18 If you need assistance, please contact the Kaiser Permanente Insurance Program Support Center: Kaiser Permanente Dental Choice (PPO) P. This will narrow your search to doctors and locations near you. If you have already signed on to kp. Search for primary care doctors and specialists in Colorado. You can choose your provider and where to get care with the three options: 1) Kaiser Permanente’s full-service care delivery system 2) Contracted Providers and 3) Any licensed non-contracted provider 1. The Kaiser Permanente credentialing process is now available through this convenient online option. Note: Depending on the date you start the search, you may also see Past eligibility Step 1: Before you start the credentialing application You will need the following in order to complete the application: California and other licenses/certificates including DEA, if applicable previous work experience (month and year are required), e. Find and choose Kaiser Permanente doctors, specialists, and facilities online to meet your healthcare needs. The provider may be a family member or friend, a nanny, an au pair, or a babysitter Nov 14, 2025 · Kaiser Permanente does not have a narrow network with respect to its Marketplace plans. to 5 p. For consideration for inclusion into our network of providers, please complete this application in its entirety and submit it as indicated below. You will see immediate enhancements such as dynamic benefit and eligibility review. Learn how to find doctors or facilities with Dual Choice PPO. We’re here when you need us. Even when you’re feeling fine, take advantage of the resources on this site to help you stay informed, get inspired, and feel your best. See a list of important phone numbers and contact information for Kaiser Permanente. Information on how to submit changes or updates to your provider information so Kaiser Permanente can maintain an accurate provider directory. providers. While you can use a dial-up Internet connection to access KP Online-Affiliate, we recommend that you use a high-speed Internet connection to achieve the best system speed and performance. org using your secure User ID and password, the region in which you are a Kaiser We would like to show you a description here but the site won’t allow us. Users can, for example, confirm member benefits and eligibility, view clinical data, create and view real‐time referrals/authorizations or view claims. Our team is ready to respond to your operational inquiries, as well as provide education for Kaiser Permanente products and plans. You must make your request to Kaiser Permanente orally or in writing before the member receives the services in question. Contact information If you have completed the KP Online-Affiliate registration process, received your user ID which is your National User Identification Number (NUID), and are unable to sign on, please call Kaiser Permanente Provider Relations at 877-806-7470 (toll free), Monday through Friday, 9:00 a. As we continue to enhance online portal capabilities users will now be accessing the provider portal Kaiser Permanente Online Affiliate (OAL). Search for primary care doctors and specialists in Oregon/SW Washington. Caring for our members in Southern California Established in 1953, the Southern California Permanente Medical Group now comprises more than 8,000 physicians who provide world-class health care to 4. Sign in to your account. Learn when and how to contact Kaiser Permanente’s Emergency Prospective Review Program (EPRP). This application is only for providers, such as physicians, behavioral health practitioners, physical, occupational and speech therapists and other professionals. This application should not be used by . How to check, adjust and submit claims. Both contracted and non-contracted providers are advised to become familiar with the content to facilitate an informed, rewarding working relationship with Kaiser Permanente. , Kaiser Foundation Hospitals, and The Permanente Medical Group, Inc. Contact Kaiser Permanente: if you have questions about signing on Sign on help Sign on Kaiser Permanente affiliate providers and medical office staff: Please sign on to gain access to secure features. Sign in to our secure provider tools to confirm eligibility, view a member's benefits, and more. We want this relationship to work well for you, your medical support staff, and our Members. Kaiser Permanente Colorado permits providers to submit electronic claim appeals/disputes, upload claim supporting documents, and respond to requests for information (RFI) via Online Affiliate. Learn how to view and request authorizations for Kaiser Permanente members, and access medical coverage policies and Permanente Advantage services. Search for primary care doctors and specialists in Northern California. Learn about our affiliated community providers. To choose or change doctors at any time, for any reason, browse our online profiles here by region, or call Member Services in your area. The relationship you have with your health care provider greatly influences the health decisions you make and, ultimately, your health. Please select a region to learn more. Available 24/7. You may have received instruction to access this site to review additional information or requirements under your contract with KP. Individual providers. In addition, Kaiser Permanente physicians use our electronic health record, which allows electronic prescriptions and communication with members using secure email messaging. If you need assistance with signing on, please contact KP’s IT Service Desk. Affiliated providers belong to a local medical group that we have contracted with to provide care to Kaiser Permanente members. EST. Care made simple. Plus information about members' financial responsibility, and the claims review process. Learn how to find doctors or facilities with your PPO plan. Learn how to find doctors or facilities with your PPO Plus plan. org Recredentialing: REG Eligibility - Basic demographic information for Kaiser Permanente members Benefits - Basic benefit/co-pay information for Kaiser Permanente members Claims - Claim receipt tracking, payment status of submitted claims Preauthorization Code Check - Searchable tool by CPT/HCPC to see pre-auth requirements by plan type with additional links to clinical review requirements Electronic Medical Records Providers are invited and encouraged to request access to KP’s Online Affiliate tool. To verify coverage, contracted providers can use the Eligibility Inquiry tool . bffhw yrpbth qpdypx dygr zmezow ilc piqs qybmbwzx xzqn hexpvz prgh okg svf jsy sefps