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Member Benefits
Consult the section of the appropriate provider manual for information related to member benefits:
- Refer to the HMO Provider Manual for HMO member benefits and eligibility
- Refer to the Self-funded Provider Manual for Self-funded members benefits and eligibility
Secure online access to Online Affiliate
If you are a contracted provider, you may qualify for secure online access to verify insurance coverage and review member demographics and benefits information (i.e., co-pays, covered services).
Member rights and responsibilities
Our members can expect to be treated professionally, be involved in the decision-making process, and receive safe and ethical care.
Members who disagree with a decision have the right to make an appeal. Consult the section of the appropriate provider manual to learn about our members’ rights and responsibilities and appeals processes:
Grievances
A member complaint or grievance may relate to quality of care, access to services, provider/staff attitude or any number of other reasons. If a member wants to file a grievance, please have them complete one of these two forms and return it to Kaiser Permanente as instructed on the form. Providers are obligated to make these forms available upon request.
For use by Medicare-eligible Kaiser Permanente members (e.g., Kaiser Permanente Senior Advantage, Medicare Cost)
For use by all other Kaiser Permanente members.