Permanente Advantage provides pre-certification for medical services ONLY for Kaiser Permanente Insurance Company (KPIC) Point-of-Service (POS) and Preferred Provider PPO plan members. Permanente Advantage provides determination using evidence-based, nationally established criteria. As a URAC certified organization in Health Utilization Management (HUM), this exemplifies our commitment to high performance by embedding quality management principles into our daily operations. The certification process verifies and confirms our operational soundness, developed policies and procedures, set priorities, and identified organizational improvements.
Verification of pre-certification is required in advance prior to services being rendered, excluding emergency services. Pre-certification requests should be submitted by a healthcare provider. Any provider wishing to provide services listed under the individual member’s Certificate of Insurance (COI) is required to call, verify, and submit in advance a pre-certification request along with clinical information. You may submit your completed request form with supporting clinical documentation by fax or email to the following:
Fax #: 866-338-0266
Email: PermAdvantageTeam-KPPA@kp.org
Link to Permanente Advantage Pre-Certification Request Form.
Failure to follow the pre-certification instructions may result in delay of processing your request or a denial of the request and possible non-payment for services, if rendered.