Kaiser Permanente Claims Address Phone Number (2024)

Kaiser Permanente is one of the United States’ biggest not-for-profit health plans, serving approx 12.4 million members. At Kaiser Permanente, physicians are answerable and responsible for medical decisions and actions. The Permanente Medical Groups provides care for Kaiser Permanente members and continuously develops and improves medical practices to help and ensure that care is delivered in the most efficient and effective manner possible. We have created a list of Kaiser Permanente claims address and phone numbers to help people to submit health claims easily and get reimbursement of their medical bills.

Kaiser Permanente is a leading healthcare organization that offers comprehensive health insurance plans for individuals, families, and businesses. With over 12+ million members, Kaiser Permanente is one of the largest healthcare providers in the United States of America. If you’re considering Kaiser Permanente insurance, you’ve come to the right place. This article will provide an overview of Kaiser Permanente insurance, including the plans, benefits, how to enroll, and kaiser permanente claims address more.

Kaiser Permanente Claims Address Northern California

Kaiser Referral Invoice Service Center (RISC)
2829 Watt Avenue,
Suite130, Sacramento, CA, 95821
For claims inquires and Kaiser Billing Department Phone Number	1-800-390-3510

kaiser Permanente Claims Mailing Address California Claims Address

Kaiser Foundation Health Plan Inc
Claims Department, PO Box-12923, Oakland, CA- 94604-2923

Member Service Phone Number- 1-800-390-3510

Kaiser Permanente Northern California Claims Address

Northern California Region
KFHP Claims Department
P.O. Box 12923, Oakland, CA 94604-2923

Claims for DME, SNF, Home Health, and Hospice services:

DME Claims Continuum Processing Center
320 Lennon Lane
Walnut Creek, CA 94598
For inquiries for DME claims and billing information Phone No.	800-337-0115 (Toll-free)

Claims Address for part of a transplant case:

Kaiser Permanente Transplant Claims Processing Unit

1950 Franklin St, 7th Floor

Oakland, CA 94612

KPIC Self-Funded:

Contact 866-213-3062 (toll free) for instructions on electronic claims submission. Kaiser Permanente’s payer ID number is 94320.

By U.S. mail:
KPIC Claims Administrator
P.O. Box 30547
Salt Lake City, UT 84130-0547
claims filing requirements or statuses Contact Phone number	866-213-3062

Kaiser Claims Address Southern California & Kaiser Permanente Billing Phone Number Southern California

HMO/DHMO/Senior Advantage members

Contact 866-285-0361 (toll free) for instructions on electronic claims submission.

By U.S mail:
Kaiser Foundation Health Plan, Inc.
Claims Administration Department
P.O. Box 7004
Downey, California- 90242-7004
For inquiries on DME claims and billing information Phone No.	800-390-3507 (Toll-free)
For claims inquires and issues call at Phone No.	800-390-3510

Kaiser Permanente Southern California Claims Address

Kaiser Permanente Southern California Claims Address is mentioned as below

Kaiser Foundation Health Plan Inc
Claims Department, PO Box-7004, Downey, CA- 90242-7004

Member Service Call- 1-800-390-3510

KPIC Self-Funded EPO/Self-Funded Product members/ KPIC Fully Insured EPO/KPIC Deductible for Individuals Product members

Contact 866-921-5310 (toll free) for instructions on electronic claim submission.

By U.S. mail:

KPIC Claims Administrator

P.O. Box 30547

Salt Lake City, UT 84130-0547

For KPIC Self-Funded EPO/Self-Funded Product members claims filing requirements or status Phone No. 800-533-1833

KPIC Fully Insured EPO/KPIC Deductible for Individuals Product members claims filing requirements or status Phone No. 866-213-3065

Kaiser Permanente Phone Number and Claim Address- Colorado:

Please mail paper claims or any supporting documentation to below mention address

Kaiser Permanente of Colorado
Claims Administration
P.O. Box 373150
Denver, CO 80237
For claims inquiries and issues, please call at Phone No.	303-338-3600

Kaiser Permanente Self-funded claims- Colorado

KPIC – SF Claims Administration
P.O. Box 30547
Salt Lake City, UT 84130-0547
For claims inquiries and issues, please call at phone No.	1-877-883-6698

Note-

1-All claims must include the member’s Health/Medical Record number.

2-All claims must be submitted on a CMS 1500 form for professional claims or CMS 1450 form (UB-40) for a facility or hospital claims.

3-charges should be submitted no later than 90 days from the date of service.

Kaiser Permanente Phone Number and Claim Address- Georgia:

Please mail paper claims and Other documents Address

National Claims Administration – Georgia
P.O. Box 370010
Denver, CO 80237-9998
For claims for inquiry and issues call at Phone No.	404-261-2825 / 888-895-5813 (Toll-free)

Kaiser Permanente Self-funded claims- Georgia

Paper claims and correspondence mailing Address:

KPIC – SF Claims Administration
P.O. Box 30547
Salt Lake City, UT 84130-0547
For claims, inquiry and issues call at Phone no.	1-866-800-1486

Note-

1-All claims must include the member’s Health/Medical Record number.

2-All claims must be submitted on a CMS 1500 form for professional claims or CMS 1450 form (UB-40) for a facility or hospital claims.

3-charges should be submitted no later than 90 days from the date of service.

Kaiser Permanente Phone Number and Claim Address- Hawaii

Please send paper claims and other supporting documents to below mention address

Hawaii Claims Administration
P.O. Box 378021
Denver, CO 80237
For claims inquires and issues call at Phone No.	877-875-3805

Kaiser Permanente Phone Number and Claim Address- Mid-Atlantic States:

Please mail paper claims and other supporting documents to below mention address

Mid-Atlantic Claims Administration
P.O. Box 371860
Denver, CO 80237-9998
For claims inquires and issues call at Phone No.	800-777-7902

Kaiser Permanente Phone Number and Claim Address- Northwest:

Please send paper claims and other supporting documents to below mention address

National Claims Administration – Northwest
P.O. Box 370050
Denver, CO 80237-9998
For claims inquires and issues call at Phone No.	503-735-2727

Kaiser Permanente Phone Number and Claim Address- Washington:

Please send paper claims and other supporting documents at below address

Kaiser Permanente Claims Administration
P.O. Box 34585
Seattle, WA 98124-1585
For claims inquires and issues call at	509-241-7206 /1-888-767-4670.

What is Kaiser Permanente California payer ID?

Kaiser Permanente California is 94134 Payer ID.

Kaiser Permanente Downey Medical Center

Address: 9333 Imperial Hwy. Downey, CA 90242, USA

Phone Number- +1 833-574-2273

How to Sign Up kaiser Permanente?

For additional information on accessing Online Affiliate, please visit providers.kp.org and choose your specific region from the dropdown menu.

To set up access to Online Affiliate, you can follow these steps:

1. Visit the providers.kp.org website.
2. Navigate to the home page or go to the claims tab.
3. Follow the provided instructions for setting up access to Online Affiliate.

If you require further assistance, you can contact your regional Online Affiliate representative using the following contact details:

Region	Contact Email
Southern California	[email protected]
Northern California	[email protected]
Colorado	providers.kp.org/co
Mid-Atlantic	[email protected]
Northwest	[email protected]
Hawaii	[email protected]
Georgia	[email protected]

Kaiser Permanente EDI Trading Partners and Payer List

Clearing house	Northern CA	Southern CA	Hawaii	Georgia	Northwest	Mid-Atlantic	Colorado
ChangeHealthcare(CHC)	94135	94134 payer id	94123	21313	93079	52095	91617
OptimumInsight/Ingenix	NA	NA	NA	NG010	NG009	NG008	COKSR
Navicure	NA	NA	NA	21313	NA	NA	NA
Office Ally	94135	94134 payer id	NA	NA	NW002	52095	NA
Availity (formerly REALMED)	NA	N/A	NA	NA	NA	54294	NA
Relay Health	RH009	94134 payer id	RH0011	RH008	RH002	RH010	RH003
SSI	NKAISERCA	SKAISERCA	NA	21313	SS002	NA	999990273

Regional Clearing house Payer IDs for kaiser Permanente?

Clearinghouse	Northern CA	Southern CA	Hawaii	Georgia	Northwest	Mid- Atlantic	Colorado
Chaim leAlthcftrA	94135	94134	94123	21313	93079	52095	91617
(Cic)
QP_031110.111,sigilaacttalc.	WA’	NIA*	VA’	ING010	NIG009	NG008	COKSR
IllaYlcure	NIA’	NIA*	NM’	21313	N/A”	N/A’	NIA*
Office Ally	94135	94134	NVA*	NIA*	NW002	52095	NIA*
ayailily (formerly REACHED)	NM*	N/A.*	NfA*	NIA*	N/A*	54294	WA*
Relay Health (now ClIllagale.41.41)D1W	RHDD9	94134	RHDDI t	RHOOS	RH002	RH010	RH003
SSI	NKAISERCA	SKAISERCA	NIA*	21313	SS002	N/A”	99999027

What is Kaiser Permanente Insurance?

Kaiser Permanente insurance is a health insurance plan offered by Kaiser Permanente. The insurance plans cover various medical services, including preventive, hospitalization, emergency, and prescription drugs. The programs also provide access to a network of doctors, specialists, and hospitals. Kaiser Permanente insurance is available in several states across the United States, including California, Colorado, Georgia, Hawaii, Oregon, Washington, and more.

Kaiser Permanente Insurance Plans: Kaiser Permanente offers several types of insurance plans, including:

1. HMO Plans – HMO plans require choosing a primary care physician to manage your health care needs. You’ll need a referral from your primary care physician to see a specialist.
2. PPO Plans – PPO plans allow you to see any doctor or specialist without a referral. However, you’ll save money if you choose a doctor within the Kaiser Permanente network.
3. POS Plans – POS plans combine features of both HMO and PPO plans. You’ll need to choose a primary care physician, but you can see specialists outside the Kaiser Permanente network.

Benefits of Kaiser Permanente Insurance: Kaiser Permanente insurance offers a wide range of benefits, including:

1. Preventive Care – All Kaiser Permanente insurance plans cover preventive care services, such as annual check-ups, immunizations, and cancer screenings.
2. Hospitalization – Kaiser Permanente insurance covers hospitalization expenses, including room and board, nursing care, and surgery.
3. Emergency Care – Kaiser Permanente insurance covers emergency care expenses, including ambulance services, emergency room visits, and urgent care visits.
4. Prescription Drugs – All Kaiser Permanente insurance plans cover prescription drugs. You’ll pay a co-pay or coinsurance for each prescription.

How to Enroll in Kaiser Permanente Insurance?

Enrolling in Kaiser Permanente insurance is easy. You can enroll online or by phone. To register online, visit the Kaiser Permanente website and select your state. You’ll be asked to provide basic information about yourself and your family. You can also enroll by phone by calling the Kaiser Permanente customer service number.

How much does Kaiser Permanente insurance cost?

The cost of Kaiser Permanente insurance depends on your chosen plan, location, and age. You can get a personalized quote by visiting the Kaiser Permanente website.

Permanente Insurance offers a comprehensive range of health insurance plans, including HMO, PPO, and POS plans to suit your needs. Their plans cover preventive care, hospitalization, emergency care, and prescription drugs. Kaiser Permanente’s network includes top-notch doctors, specialists, and hospitals, ensuring you receive high-quality healthcare services.

Total Staffed Beds:	352
Total Patient Revenue:	$2,699,938,672
Total Discharges:	15,926
Total Patient Days:	72,198

Kaiser Permanente Customer Service

Local Calling Area-  (301) 468-6000.

Outside the Local Calling Area- 1-800-777-7902 

Kaiser Permanente Provider Dispute Resolution Process

Kaiser Permanente actively encourages our contracted Providers to make use of MSCC staff for addressing billing and payment concerns.

If you are still unable to resolve your billing and payment issues, Kaiser Permanente insurance offers a swift, equitable, and cost-effective dispute resolution process for conflicts related to invoices, billing determinations, or other contract matters. This dispute resolution procedure adheres to applicable legal standards and your Agreement. It’s essential to note that the process outlined here applies specifically to disputes subject to the Knox-Keene Act. While we anticipate utilizing this process for other dispute types, it is not obligatory.

This section of the Provider Manual provides an overview of our dispute resolution process, but it should not be considered a comprehensive explanation of the law or your Agreement’s provisions. We strongly advise reviewing your Agreement and relevant laws for a thorough understanding of the dispute resolution process. If your Agreement explicitly outlines a longer timeframe or additional processes beyond what is described below, those contractual provisions will take precedence to the extent they do not conflict with applicable law.

Types of Disputes The following outlines the most frequent dispute categories:

• Claims Payment Disputes: These involve challenging, appealing, or requesting reconsideration of a denied, adjusted, or contested claim (or a group of bundled claims) by KP.

• Responding to Requests for Overpayment Reimbursements: This pertains to disputes initiated by KP, seeking reimbursement from you for overpayment on a claim.

• Other Disputes: These encompass the resolution of contract disputes (or groups of bundled contract disputes) between you and KP.

Submitting Payment Disputes

• Payment Disputes can be submitted online via Online Affiliate or through written notice to KP via U.S. Mail or other physical delivery.

Directions for Submission of Payment Disputes

• Payment Disputes Related to Referred Service Claims: Online or by U.S. Mail.

For more information or to register for Online

Affiliate, please visit KP’s Northern California Community Provider Portal at:

http://providers.kaiserpermanente.org/nca/

• Payment Disputes Related to Emergency Services Claims: Online or by U.S. Mail or other physical delivery.

By U.S. Mail:

Kaiser Foundation Health Plan, Inc

National Claims Administration Attention:

Provider Dispute Services Unit, P.O. Box 23100, Oakland, CA 94623

National Claims Administration Attention:

Provider Dispute Services Unit, P.O. Box 23100, Oakland, CA 94623

By Physical Delivery Other than by U.S. Mail:           

Kaiser Foundation Health Plan, Inc., National Claims Administration, 1800 Harrison Street, 8th Floor , Oakland, CA 94612

• Payment Disputes Related to Visiting Member Claims: Contact Member’s “Home” region’s Medical Service call Center.

Questions  about filing a payment dispute and the status of previously submitted disputes, contact KP through Online Affiliate or by calling:

(800) 390-3510.

Required Information for Provider Payment Dispute Notices

• Your name, tax identification number, and contact information.
• Clear identification of the disputed item, including KP’s original claim number, date of service, and a clear explanation of the basis for the dispute.
• For disputes involving Members, include their name(s) and KP Medical Record Number(s) (MRN(s)).

Time Period for Submission of Provider Dispute Notices

• Provider Dispute Notices must be received by KP within 365 calendar days from the action that led to the dispute or within 365 calendar days after the time for contesting or denying a

Timeframes for Acknowledgment and Determination of Provider Dispute Notices

• KP will acknowledge receipt within 15 Business Days for hardcopy submissions or 2 Business Days for online submissions.
• Incomplete disputes will be rejected and require resubmission.
• A resolution letter will be issued within 45 Business Days after receipt of a complete Provider Dispute Notice.

Instructions for Resolving Substantially Similar Payment Disputes

• Reach out to KP resources for assistance if considering more than 20 substantially similar payment disputes.
• Substantially similar disputes can be submitted in writing in batches, including specific information for each claim and the basis for each dispute.
• Incomplete submissions will be rejected.
• Ten or more disputes within five Business Days with the same dispute reason can be considered as a single dispute.

Disputing Requests for Overpayment Reimbursements

• Follow the instructions in Section 6, Provider Dispute Resolution Process.

Other Disputes

• Refer to your Kaiser Permanente Health Care Services Agreement for disputes not based on claim adjudication or billing determinations.

To access your Kaiser Permanente account, you need to follow these simple steps:

1. Go to the Kaiser Permanente website at kp.org.
2. Click on the “Sign on” button located at the top right corner of the homepage.
3. Enter your username and password in the respective fields.
4. Click on the “Sign on” button to access your account.

Forgot Your Kaiser Permanente Login Details?

If you have forgotten your Kaiser Permanente login details, don’t worry. You can easily retrieve them by following these steps:

1. Go to the Kaiser Permanente website at kp.org.
2. Click on the “Sign on” button located at the top right corner of the homepage.
3. Click on the “Forgot username or password?” link located below the sign-on button.
4. Choose whether you want to retrieve your username or password.
5. Follow the prompts to retrieve your login details.

Kaiser Permanente Login Features

Once you have successfully logged in to your Kaiser Permanente account, you will be able to access a wide range of features, including:

• View Your Medical Records: You can view your medical records, including test results, immunizations, and medications.

• Schedule Appointments: You can schedule appointments with your healthcare provider and receive email reminders.

• Refill Prescriptions: You can refill your prescriptions online and track the status of your orders.

• Secure Messaging: You can communicate with your healthcare provider through secure messaging.

• Health and Wellness Resources: You can access a variety of health and wellness resources, including articles, videos, and podcasts.

Kaiser Permanente Lab Hours

Monday to Friday – 8 A.M. to 5:30 P.M.

Conclusion:

In summary, Kaiser Permanente Insurance offers excellent healthcare coverage for individuals, families, and businesses. With a wide range of plans, comprehensive benefits, and access to top-quality healthcare providers, Kaiser Permanente is an excellent choice for anyone seeking health insurance. Enrolling is easy, and you can rest assured that you’ll receive the best care from their providers. So if you’re considering health insurance, check out Kaiser Permanente Insurance Overview for a comprehensive guide to all their plans and benefits.

Kaiser Permanente Phone Number and claim addresses updated from authorized sources and web portals, if any discrepancy found email us via the contact us page, and the team will surely take care of the issue and update the information as per the availability.

FAQs

Note-

• Kaiser Permanente Billing and Payment Manual Pdf Download
• Kaiser Permanente Provider Dispute Resolution Process Pdf Download

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