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Claims information

Kaiser Permanente encourages you to submit your claims electronically. Please select the Electronic Data Interchange section under Claims to learn more about the advantages of EDI.

California - Northern
California - Southern
Colorado
Georgia
Hawaii
Mid-Atlantic States
Northwest
Washington

EDI Trading Partners

We encourage you to submit your claims electronically. Our EDI trading partners, and Payer ID’s are listed below:

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

If your clearinghouse is not directly affiliated, they may re-route claims to one of our direct trading partners!

California - Northern

We encourage you to submit your claims electronically.
Kaiser Permanente’s payer ID number is 94135. Clean claims will be paid or denied within the time frames required by applicable federal or state law. The mailing address for paper claims and correspondence is:

Unless otherwise indicated on the written Authorization for Medical Care or Patient Transfer Referral form, claims for referred services should be sent to:

Kaiser Referral Invoice Service Center (RISC)
2829 Watt Avenue, Suite #130
Sacramento, CA, 95821
For claims inquires and issues, please call 800-390-3510.

Claims for DME, SNF, Home Health, and Hospice services should be sent to:

DME Claims Continuum Processing Center
320 Lennon Lane
Walnut Creek, CA 94598
For inquiries for DME claims and billing information, call 800-337-0115 (toll-free).

Claims as part of a transplant case should be sent to:

Kaiser Permanente Transplant Claims Processing Unit
1950 Franklin St, 7th Floor
Oakland, CA 94612

KPIC Self-Funded

For KPIC Self-Funded EPO/Self-Funded Product members/KPIC Fully Insured EPO/KPIC Deductible for Individuals Product members, claims for services must be sent to the following:

We encourage you to submit your claims electronically.
Kaiser Permanente’s payer ID number is 94320.
By electronic delivery:
Contact 866-213-3062 (toll free) for instructions on submitting electronic claims.

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

California - Southern

Please mail paper claims (and any necessary supporting documentation) to:

HMO/DHMO/Senior Advantage members

For HMO/DHMO/Senior Advantage members, claims for services must be sent to the following:

We encourage you to submit your claims electronically.
Kaiser Permanente’s payer ID number is 94134.
By electronic delivery:
Contact 866-285-0361 (toll free) for instructions on submitting electronic claims.

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, call 800-390-3507 (toll-free).
For claims inquires and issues, please call 800-390-3510

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

For KPIC Self-Funded EPO/Self-Funded Product members/KPIC Fully Insured EPO/KPIC Deductible for Individuals Product members, claims for services must be sent to the following:

We encourage you to submit your claims electronically.
Kaiser Permanente’s payer ID number is 94320.
By electronic delivery:
Contact 866-921-5310 (toll free) for instructions on submitting electronic claims.

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 statuses contact 800-533-1833.

KPIC Fully Insured EPO/KPIC Deductible for Individuals Product members claims filing requirements or statuses contact 866-213-3065.

Colorado

We encourage you to submit your claims electronically.
Kaiser Permanente’s payor ID number is 91617. Complete claims will be paid or denied within the time frames required by applicable federal or state law.

Please mail paper claims (and any necessary supporting documentation) to:

Kaiser Permanente of Colorado
Claims Administration
P.O. Box 373150
Denver, CO 80237
For claims inquiry and issues, please call 303-338-3600.

Self-funded claims
For self-funded claims, the payor ID is 94320. Complete claims will be paid or denied within the time frames required by applicable federal or state law.

Paper claims and correspondence should be mailed to:

KPIC – SF Claims Administration
P.O. Box 30547
Salt Lake City, UT 84130-0547
For claims inquiry and issues, please call 1-877-883-6698

All claims must include the member’s Health/Medical Record number. Kaiser Permanente does not recognize Social Security numbers as policy numbers. All claims must be submitted on a CMS 1500 form for professional charges or CMS 1450 form (UB-40) for facility charges. NPI numbers are required. Unless otherwise specified in your contractual agreement, charges should be submitted concurrently, but no later than 90 days from the date of service.

Georgia

We encourage you to submit your claims electronically.
Kaiser Permanente’s payer ID number is 21313. Clean claims will be paid or denied within the time frames required by applicable federal or state law.

Please mail paper claims (and any necessary supporting documentation) to:

National Claims Administration - Georgia
P.O. Box 370010
Denver, CO 80237-9998
For claims for inquiry and issues, please call 404-261-2825 or 888-895-5813 (toll-free)

Self-funded claims
For self-funded claims, the payor ID is 94320. Complete claims will be paid or denied within the time frames required by applicable federal or state law.

Paper claims and correspondence should be mailed to:

KPIC – SF Claims Administration
P.O. Box 30547
Salt Lake City, UT 84130-0547
For claims inquiry and issues, please call 1-866-800-1486

All claims must include the member’s Health/Medical Record number. Kaiser Permanente does not recognize Social Security numbers as policy numbers. All claims must be submitted on a CMS 1500 form for professional charges or CMS 1450 form (UB-40) for facility charges. NPI numbers are required. Unless otherwise specified in your contractual agreement, charges should be submitted concurrently, but no later than 90 days from the date of service.

Hawaii

We encourage you to submit your claims electronically.
Kaiser Permanente’s payor ID number is 94123. Complete claims will be paid or denied within the time frames required by applicable federal or state law.

Please mail paper claims (and any necessary supporting documentation) to:

Hawaii Claims Administration
P.O. Box 378021
Denver, CO 80237
For claims inquires and issues, please call 877-875-3805.

Mid-Atlantic States

We encourage you to submit your claims electronically.
Kaiser Permanente’s payor ID number is 52095. Complete claims will be paid or denied within the time frames required by applicable federal or state law.

Please mail paper claims (and any necessary supporting documentation) to:

Mid-Atlantic Claims Administration
P.O. Box 371860
Denver, CO 80237-9998
For claims inquires and issues, please call 800-777-7902.

Northwest

We encourage you to submit your claims electronically.
Kaiser Permanente’s payor ID number is 93079. Complete claims will be paid or denied within the time frames required by applicable federal or state law.

Please mail paper claims (and any necessary supporting documentation) to:

National Claims Administration - Northwest
P.O. Box 370050
Denver, CO 80237-9998
For claims inquires and issues, please call 503-735-2727.

Washington

Mail paper claims (and any necessary supporting documentation) to:

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

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