The first step in gaining access to Kaiser Permanente’s Online-Affiliate tool for your Practice, Group, or Facility is the Completion of our Online Affiliate Enrollment Agreement. The Entity Agreement needs to be signed by an Owner, CEO, CFO, VP, or other Executive.
Be advised that we only require one Provider Entity Agreement per Tax ID for each region you wish to access. This agreement outlines the conditions and responsibilities that the authorized signer must assume for any individual user who associates themselves with the Practice, Group, or Facility.
Unsure whether we have an agreement on file for your provider group?
You may verify by submitting an Online Affiliate Support Case with your group name and Tax ID. Someone will respond to confirm if we have an agreement on file.
Please read, sign, and return the Provider Entity Agreement using our webform1:
Submit Online Affiliate Enrollment Agreement
*** DO NOT PROCEED UNTIL STEP 1 IS COMPLETE ***
1Receipt of signed Providers Entity Agreement does not guarantee requests for Online Affiliate access will be granted.