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Benefits of using EDI for claim submissions
- Reduced Overhead Expenses - Administrative overhead expenses are reduced, because the need for handling paper claims is eliminated.
- Improved Data Accuracy - Because the claims data submitted by the provider is loaded directly into Kaiser Permanente’s computer by the clearinghouse, data accuracy is improved, as there is no need for re-keying or re-entry of data.
- Additionally, “up-front” edits applied to the claims data while information is being entered at the provider’s office, and additional payer-specific edits applied to the data by the clearinghouse before the data is transmitted to the appropriate payer for processing, increase the percentage of clean claim submissions.
- Reduced Turnaround Time - EDI claims bypass manual processes and paper handling at Kaiser Permanente; therefore, the turnaround time for processing EDI claims is substantially reduced (as compared to processing ...paper claims).
- Bypass U.S. Mail Delivery - Providers save time by bypassing the U.S. mail delivery system.
- Reduced Payer-Specific specific “Exceptions” - Industry-accepted standardized medical claim formats will tend to reduce the number of “exceptions” currently required by multiple payers.
Electronic Submission of Claims Types
Listed below is the electronic submission of claims transactions:
- 837P Claim/Encounter - This is used for professional services and supplier.
- 837I Claim/Encounter - This is used by facilities and hospitals.
Please note: Payer IDs are for both 837I (UB) and 837P (CMS1500) transactions.
EDI Trading Partners
| Clearing house | Northern CA | Southern CA | Hawaii | Georgia | Northwest | Mid-Atlantic | Colorado |
| Office Ally | 94135 | 94134 | 94123 | 21313 | NW002 | 52095 | 91617 |
| Navicure | N/A | N/A | N/A | 21313 | N/A | N/A | N/A |
| Availity (formerly REALMED) | N/A | N/A | N/A | N/A | N/A | 54294 | N/A |
| SSI | NKAISERCA | SKAISERCA | 94123 | 21313 | SS002 | 52095 | 999990273 |
| Trizetto | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| Zirmed | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| Relay Health Alternate IDs | RH009 94135 KS003 |
94134 KS001 |
RH0011 94123 |
RH008 21313 NG010 |
RH002 93079 NG009 |
RH010 NG008 |
RH003 91617 COKSR |
Claims submission through Office Ally for bulk claims submissions and for direct entry claim submissions to Kaiser Permanente. Claims submissions to KP are FREE for providers.
- Learn about submitting via Office Ally
- Submit claims electronically and receive confirmation immediately
- Convenient, secure, and HIPAA compliant
- 24/7 access from anywhere with an internet connection
Sign up for Office Ally here.
Instructions: Under Practice Software section, select “Clearinghouse”, “Start for Free”, and “Signup”
Electronic Payment and Remittance Advice Online Enrollment
Kaiser Permanente has partnered with Citi Payment Exchange to provide a portal for enrolling in Electronic Fund Transfer (EFT) and Electronic Remittance Advice (ERA). With this partnership, Kaiser Permanente requests that all vendors pursuing EFT/ERA enrollments utilize the Payment Exchange portal for enrollment and changes to existing EFT/ERA. The portal is open 24 hours a day and 7 days a week for new enrollments or changes.
Reduce turn-around-time for receipt of payments and remove overhead costs associated with handling paper correspondence by signing up for EFT/ERA today.
It’s easy to get started now!
Each Kaiser Permanente region requires a separate enrollment.
If you wish to create a new enrollment for EFT/ERA in the Hawaii region
Click here to enter a secure portal.
Activation code 3PZFK2 is required at login.
Frequently Asked Questions
What if I already have EFT/ERA set up with Kaiser Permanente? Will I need to re-enroll through Citi Payment Exchange?
No, vendors with EFT/ERA already in place at Kaiser Permanente will have their account set up on their behalf. You will receive an invitation from Citi Payment Exchange to sign in and make changes or additions to your existing account. If you do nothing, your current EFT/ERA arrangements will remain as they are today.
If I’ve submitted a change or an enrollment request, what will be the turnaround time to complete the request?
Continue to check Citi Payment Exchange for status updates. Once approved in the portal, Kaiser Permanente will require 7-10 business days to update the system. If you continue to receive paper checks, contact EDI Support by submitting a Support Case to: https://kpnationalclaims.my.site.com/EDI/s/
Can I remove a bank account from my profile in Citi Payment Exchange?
Yes, you can also unshare a bank account with a region/payer under Settings.
The provider may have more than one bank account set up per region (sub designations are made by adding an NPI) and UNSHARE is the appropriate action if you want to keep one account in play but remove another one.
Can I change my demographic information through Citi Payment Exchange?
No, any demographic information changes need to be handled through Kaiser Permanente. Contact EDI Support by submitting a Support Case for more information: https://kpnationalclaims.my.site.com/EDI/s/
If I sign up for EFT in Georgia, will my California claim payments be automatically included?
No, you’ll need to request each region if not autoloaded in the initial set up of Payment Exchange.
Go to NEW region URL – sign in with activation code - using the specific activation code notifies the specific region of a new request. If the activation code is not used, the region isn’t notified of a new enrollment.
When Citi automation sees the provider information already exists, a message will pop up and direct the billing provider to log into their existing account. Once logged in and the established password is entered, the request for the new region will pop up in the “established accounts” list and the provider will be asked to link it to the existing account.
There is no limit to the number of regions a provider can be registered to bill. Providers who have multiple regions registered will all show in the “established accounts”. If you do not see your preferred region on this list, please contact EDI Support by submitting a Support Case to: https://kpnationalclaims.my.site.com/EDI/s/
Can I cancel my EFT/ERA setup?
Yes, you can revoke the link between your account and the EFT/ERA vendor.
Within the Payment Exchange portal, provider will select Payers > click the Payer > then select Revoke. That will cancel the enrollment altogether with that payer (region).
Important Note: If you are a provider retrieving ERAs from a clearinghouse, you must remember to complete the ERA setup with your clearinghouse as well as with Kaiser Permanente via the Citi Payment Exchange portal.