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The Code of Conduct highlights some provisions in the provider agreement as well as the minimum standards by which providers are expected to conduct themselves when serving Kaiser Permanente members and patients.
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Provider information
Our policies cover topics from provider responsibilities to compliance. We've provided links to policies and procedures for some of our most important programs.
- Kaiser Permanente Medical Care Program
- Primary care physician services and responsibilities
- Compliance and regulatory policy
- Quality and health management
- Clinical Review Payment Determination Policy
If you have questions about policies that aren't listed here or that you can't find in other areas of this website, please call Provider Relations at 1-877-806-7470 (toll free).
Provider Manuals
These provider manuals are a guide for contracted providers to use when interacting with Kaiser Permanente of the Mid-Atlantic States. They are intended to provide explanations of how processes work within our organization.
The provider manual includes provisions for both the fully insured program and the self-funded program. Please determine which program will most appropriately help you.
Index: Table of Contents
Chapter 1: The Kaiser Permanente Medical Care Program
Chapter 2: Patient medical centers and network resources
Chapter 3: Products, delivery systems, and member ID cards
Chapter 4: Enrollment and eligibility
Chapter 5: Member rights, complaints, and appeals/grievances
Chapter 6: Primary care physicians services and responsibilities
Chapter 7: Compliance and regulatory policy
Chapter 8: Claims
Chapter 9: Utilization management and authorization
Chapter 10: Quality and health management
Chapter 11: Laboratory services
Chapter 12: Radiology services
Chapter 13: Pharmacy services
Chapter 14: Behavioral health services
Chapter 15: Kaiser Permanente's Flexible Choice Plan
Chapter 1-15: Self-Funded Program
Sections I-VI: Maryland HealthChoice program
You can obtain a full copy of our provider manual in two ways:
By mail: download this form to request that we send you a provider manual.
Download a copy of our provider manual by chapter.
Newsletters
Our newsletters for Kaiser Permanente network providers offer timely information for practitioners and office managers, including updates about new programs and services.
Expand your knowledge and enhance patient care.
Kaiser Permanente’s Clinical Library provides clinical reference materials for providers including: clinical practice guidelines, drug information, member education, textbooks, journal references and much more. Access anywhere, anytime via the web or mobile app.
Manage your account
You will need a NUID (National User ID) to access Clinical Library. If you are not signed up for a NUID, please click here* to register for access.
Now you can search for physicians, departments, facilities, and more, all in one place. Just select your area and choose the way you prefer to search. You can even narrow your results to find exactly what you need. Get phone numbers and addresses at a glance, or visit doctor and location home pages for detailed information.