Member information

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• View a member's medical record

Kaiser Permanente is committed to providing members with quality health care services. Our members can expect to be treated professionally, be involved in the decision-making process, and receive safe and ethical care.

Learn about all of our members’ rights and responsibilities:

• For commercial members, see the Annual Subscriber Notice.
• For Medicare members, see the Medicare Annual Subscriber Notice.
• For MD HealthChoice members, see the Maryland HealthChoice Member Handbook.

For information on our privacy practices, go to kp.org.

The Mid-Atlantic States Member Services department has representatives to assist both providers and members who call for:

• general verification of member eligibility/enrollment
• clarification of member benefits and coverage
• information about services available at our medical facilities
• maps, driving directions, and other literature
• status or payment information related to a claims submission
• information about or assistance with filing a grievance, appeal, or complaint
• assistance with solving a problem
• information about plan providers and assistance with selecting a primary care physician
• requests for replacement Kaiser Permanente member identification card(s)
  requests by a member to change the member's address or phone number
  

Mid-Atlantic States Member Services representatives can be reached Monday through Friday, from 7:30 a.m. to 5:30 p.m.

• inside the local calling area: (301) 468-6000
• outside the local calling area: 1-800-777-7902
• TTY for the hearing/speech impaired: (301) 879-6380
  

All members have the right to file a compliment or complaint with Kaiser Permanente.

Please let members who have concerns know that they can contact a representative at the Kaiser Permanente Customer Service Center. They may call:

• inside the Washington metro calling area: (301) 468-6000
• outside the Washington metro calling area: 1-800-777-7902
• TTY for the hearing/speech impaired: (301) 879-6380

Member assistance and resource specialists are also available at most Kaiser Permanente medical centers in the center's administration office.

Members may also send written communications to the following address:

Kaiser Permanente
Member Relations
Ten Piedmont
3495 Piedmont Rd., NE
Atlanta, GA 30305

All compliments are shared with appropriate staff and departments. All complaints are investigated and resolved by the Member Service representative through coordination with the appropriate departments.

Members have the right to file a grievance or appeal when they disagree with the Health Plan's decision not to authorize necessary medical services or not to pay for a claim.

For urgent situations, or for more information, members may contact a Member Services representative at the Kaiser Permanente Customer Service Center by calling:

• inside the local calling area: (301) 468-6000
• outside the local calling area: 1-800-777-7902
• TTY for the hearing/speech impaired: (301) 879-6380

After business hours, for medically urgent situations, call:

• (703) 359-7878 - advice line
• 1-800-777-7904 or 1-800-700-4901 (toll-free TTY outside the Washington metro calling area)

Expedited appeals/grievances are available for medically urgent situations. Requests for an appeal or grievance should be sent in writing to the address below. The letter should include the member's name and Health/Medical Record Number, a description of the services or claim that was denied, and the reason that the Health Plan should authorize the service or pay the claim. It should also include a copy of the denial notice, if one was received.

Written appeals or grievances should be sent to:

Kaiser Permanente
Member Relations
Ten Piedmont
3495 Piedmont Rd., NE
Atlanta, GA 30305

When a Kaiser Permanente SignatureSM member chooses a Mid-Atlantic Permanente Medical Group (MAPMG) physician as his or her PCP and is covered by HMO insurance, the member will receive a white ID card with a blue stripe.

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Members covered under Kaiser Permanente SelectSM have the added option of selecting a network participating PCP. With the selection of network participating PCP, the member agrees to coordinate care through his or her designated PCP. While the face of the card resembles that of the traditional HMO membership card, the back of the card will display the group practice address and telephone number of his or her network participating PCP. The member's office visit copayment also appears on the front of the card. The member who selects a network participating PCP receives a tan ID card with a blue stripe.

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Flexible Choice member identification cards are unique. Members enrolled in Flexible Choice have three very different benefit options each time services are needed. These members have a white and blue ID card with the Kaiser Permanente logo, along with a PHCS logo and a MultiPlan logo on the back of the card. The Flexible Choice ID card also includes the words "Flexible Choice."

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Medicare Advantage cards will be provided to all members covered under a Medicare product. The Medicare Advantage ID card will display the words “Medicare Advantage”. Medicare Advantage members who choose a MAPMG physician as their PCP will receive a white card with a blue stripe.

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Kaiser Permanente offers plans that are self-funded as part of our offerings to employer groups.

Self-funded ID cards are green and will contain the logo of the employer as well as the Kaiser Permanente logo.

The self-funded program has a different Customer Service phone number: 1-877-740-4117.

There is a different payor ID and mailing address for self-funded claims.

Payor ID: 94320
KPIC, Self-Funded Claims Administrator
P.O. Box 30547
Salt Lake City, UT 84130-0547

Sign on to view self-funded eligibility, benefits, and medical claim information.

For additional information on the self-funding program, please see the Self-funded provider manual.