Kaiser Permanente provider portal, phone and payer ID quick facts
| Provider portal | https://healthy.kaiserpermanente.org/community-providers |
|---|---|
| Provider phone | Plan-specific |
| Claims payer ID | Verify in clearinghouse payer list |
| Eligibility payer ID | Not established in this registry; verify with clearinghouse |
| ERA payer ID | Clearinghouse-specific |
| Timely filing | Plan-, region- or contract-specific |
| Prior auth route | X12 278 plus provider portal |
| Last reviewed | 2026-04-23 |
- This registry has not established one national provider-services phone number for Kaiser Permanente. Use the provider portal or member ID card for plan-specific phone routing.
- This registry has not established one national timely-filing limit for Kaiser Permanente. Verify the controlling plan document, provider agreement, denial notice, or jurisdictional rule.
- This registry has not established one national ERA payer ID for Kaiser Permanente. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment.
Kaiser Permanente at a glance
| Legal name | Kaiser Foundation Health Plan, Inc. |
|---|---|
| Also known as | KP, Kaiser |
| Category | Commercial |
| Parent organization | Kaiser Foundation Health Plan, Inc. |
| Claims payer ID | Not established in this registry |
| Eligibility (270/271) payer ID | Not established in this registry |
| ERA (835) payer ID | Clearinghouse-specific |
| NAIC company code | Not established in this registry |
| States covered | California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, District of Columbia |
| Members covered | ~13 million members |
| Provider portal | https://healthy.kaiserpermanente.org/community-providers |
| Provider phone | Plan-specific |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Kaiser Permanente
A single filing deadline has not been established for this Kaiser Permanente record. Check the member's plan, regional manual, provider agreement and applicable rules before calculating the deadline.
| Submission type | Window |
|---|---|
| Initial claim reference | Plan-, region- or contract-specific |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
Reconsideration and appeal routes
- Regional provider reconsiderationVerify deadline
Kaiser Permanente reconsideration deadlines are regional and contract-specific; verify the denial notice and regional provider manual before filing.
Source: Kaiser Permanente provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Kaiser Permanente
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Kaiser Permanente accepts X12 278 prior-authorization transactions electronically. The procedures most commonly subject to prior authorization include advanced imaging, inpatient admissions, specialty pharmacy, and certain outpatient surgical procedures. Use the payer's authorization tool below to confirm requirements per CPT before scheduling a service.
Kaiser Permanente maintains a live prior-authorization code lookup tool that supersedes any cached list. Use the provider portal or the policy documents below to confirm the current PA list before rendering a service.
Top denial reasons for Kaiser Permanente
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Kaiser Permanente volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Supported | Payer ID |
|---|---|---|
| 837P / 837I claims | Yes | — |
| 270 / 271 eligibility | Yes | — |
| 278 prior authorization | Yes | Verify X12 278 routing separately |
| 835 ERA | No | Clearinghouse-specific |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
What revenue cycle teams should verify before submitting claims
- Confirm the member's Kaiser Permanente region before selecting any payer ID; Northern California, Southern California, Colorado, Georgia, Mid-Atlantic, Northwest, Hawaii, and Washington route differently.
- Use the member ID card, regional provider portal, and any single-case agreement to confirm claim address, timely filing, and appeal rights.
- For out-of-area emergency or authorized referral claims, capture the authorization number and host/home region details before submission.
Common denial and routing risks for this payer
- Routing a claim to the wrong Kaiser region or regional payer ID.
- Assuming a national timely filing window when the regional provider manual or contract controls.
- Submitting outside-provider services without the referral, emergency, or authorization context Kaiser requires.
How QuickIntell supports this workflow
- Use eligibility intake rules to capture Kaiser region, host/home identifiers, and referral status before claim creation.
- Route payer-ID selection through region-specific clearinghouse logic instead of a single national KP value.
- Attach authorization and referral evidence to claims that originate outside a Kaiser-owned delivery site.
Source checks and remaining limits
The specific findings below were compared with public primary sources on . This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
Regional routing
Kaiser's community-provider entry point asks users to select a geographic area. Retain regional routing rather than supplying one national provider phone or filing deadline.
Primary source for regional routingWashington manual scope
The Washington manual identifies contracted Washington providers as its audience and says provider contracts and legal requirements control inconsistencies. It is not a national Kaiser manual.
Primary source for washington manual scope
Not checked in this pass: Each region's filing and appeal deadlines; Enrollment totals; Payer IDs and transaction support; QuickIntell outcomes.
Sources used for this guide
State coverage
Kaiser Permanente operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
QuickIntell coverage for Kaiser Permanente
- QuickRCM
End-to-end claim lifecycle automation tuned to Kaiser Permanente's edits and adjudication patterns.
- QuickAuth
Automated prior-authorization submissions and status checks for Kaiser Permanente services that require PA.
- QuickERA
Automated 835 ERA posting from Kaiser Permanente with payment reconciliation and denial routing.
Frequently asked questions about Kaiser Permanente
Where is the Kaiser Permanente provider portal?
The Kaiser Permanente provider portal is available at https://healthy.kaiserpermanente.org/community-providers. Use it for eligibility checks, claim status, prior authorization workflows, appeals, and payer-specific routing updates. QuickIntell links to the payer's provider-facing portal as a reference and is not the official payer portal.
What is the timely filing limit for Kaiser Permanente?
A single filing deadline has not been established for this Kaiser Permanente record. Check the member's plan, regional manual, provider agreement and applicable rules before calculating the deadline.
Does Kaiser Permanente publish a single claims payer ID?
This registry has not established one claims payer ID for Kaiser Permanente. Look up the correct ID for the member's plan and transaction in your clearinghouse directory and verify against the member ID card before submission.
Does Kaiser Permanente accept electronic claims?
Yes — Kaiser Permanente accepts ANSI X12 837P and 837I electronic claims through standard clearinghouses. Real-time eligibility (270/271) is supported and X12 278 prior authorization is supported.
How do I appeal a Kaiser Permanente denial?
Identify the product, state and reason for the decision before choosing a Kaiser Permanente dispute route. The listed starting route is Regional provider reconsideration (Verify deadline). Kaiser Permanente reconsideration deadlines are regional and contract-specific; verify the denial notice and regional provider manual before filing. Verify the controlling notice and exceptions; reconsideration, appeal and external review are not always a mandatory sequence.
How long do Kaiser Permanente prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
How do providers contact Kaiser Permanente?
Providers should use the Kaiser Permanente provider portal at https://healthy.kaiserpermanente.org/community-providers for eligibility, claim status, appeals, and authorization workflows. Phone routing varies by plan and product — check the back of the member ID card for the plan-specific provider services number.
For revenue-cycle teams
Connect payer lookups to your revenue-cycle workflow
Do staff repeatedly move between payer references, eligibility checks, claim status and remittance follow-up?
- Keep this payer's official reference available to the team.
- Identify one repeated administrative task and measure its handling time.
- Evaluate the required access, exceptions and reviewer handoff before expanding automation.
Kaiser Permanente is an operational reference. Payer decisions remain with the payer. Confirm plan coverage, system access and supported actions during a scoped evaluation.
Download the illustrative workflow worksheet (PDF) · Explore the AI RCM evaluation toolkit · Model the workload and costs
Automate workflows around Kaiser Permanente requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Kaiser Permanente's current published documents before submission. CPT® is a registered trademark of the American Medical Association.