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Provider information

provider information

Resources for Contracted Professional and Institutional Providers

 Resources for contracted professional services providers:

Please email Professional-ContractRequest@kp.org with updates to your contract name and/or your contract TIN. Your assigned Contract Manager will contact you to discuss and process your changes. Your email must include:

  • Current Legal Business name/DBA on contract
  • Current contract TIN
  • New Legal Business name, DBA and/or new TIN, as applicable
  • Name, email, and phone number of the person to contact regarding the change(s)

Note: Changes to your contract name and/or TIN require an amendment to your contract. Until your contract is amended, you must continue to use your current contract name/TIN in order to avoid payment issues and/or denials.

Please download and complete our Address/Phone/Fax/Email change form and email it to KP-SCAL-Provider-Data@kp.org. Other delivery options are indicated in the form instructions.

If you are a contracted professional services provider, use this form to let us know of changes to address, phone, fax or email related to your:

  • Contract Administration: Where you want to receive your legal contract notices
  • Payment/Pay-To: Where you want to receive payment (paper checks)
  • Referral Notification: Where you want to receive referral paperwork from our referrals department
  • Place of Service: Location(s) where our members will receive care

Do not use this form to report changes to your contract name, tax identification number (TIN), or roster. Click on the appropriate link(s) below to report these changes.

If you are a contracted institutional services provider and have changes to report, please email NDANDA-PROVIDERRELATIONS@kp.org or call (626) 405-3240.

Add Practitioners to Your Contracted Group

If you have added practitioners to your group’s roster, please download and complete our Practitioner Addition Form and email it to Provider Data Services at KP-SCAL-Provider-Data@kp.org

Please include the following information in your email:

  • Contract Name
  • Contract tax identification number (TIN)
  • Credentialing contact name, phone number, and email address

Remove Practitioners from Your Contracted Group

If practitioners have left your group and you need to remove them from your group’s roster, please download and complete our Practitioner Removal Form and email it to Provider Data Services at KP-SCAL-Provider-Data@kp.org

*Please use Google Chrome or Mozilla Firefox to download these forms. If you are unable to download and need to receive the forms directly, you may email Provider Data Services at KP-SCAL-Provider-Data@kp.org

HMO Provider Manual for Contracted Institutional Providers

Self-Funded Provider Manual for Contracted Institutional Providers

ICF-DD Authorization and Billing Provider Manual Supplement

These provider manuals address certain contractual, regulatory, and other requirements for acute hospitals, SNFs, and other institutional providers contracted with Kaiser Permanente. These manuals are intended as guidelines for the provision of covered services to members and contain policies, procedures and general reference information for our institutional providers. They are intended to supplement, and not to replace or supersede, the terms and conditions of the services agreement between Kaiser Permanente and its contracted providers. In the event of any discrepancy between the terms of the applicable provider manual and your services agreement, the terms of the agreement govern.

Although these manuals contain a summary of certain Kaiser Permanente policies and procedures, additional detailed information may be available upon provider request by calling Network Development & Administration, Provider Relations, at 626-405-3240 or send an email to NDANDA-providerrelations@kp.org.

To the extent Kaiser Permanente's policies or procedures change, or the requirements of applicable legal, regulatory, accreditation, or contractual mandates change, we may need to update these manuals periodically. We will keep you informed of these changes as they occur, in accordance with your agreement and applicable law.

If you are a contracted institutional services provider, please download and complete our Provider Information update form (supporting HR 133) and email it to NDA-SCAL@kp.org.

Please use this form to confirm accuracy of current demographic data for your provider listing on kp.org:

  • Contract Administration:
    • Facility name
    • Business address – location(s) where members receive care from you
    • Business phone
    • Business email
    • Facility NPI
    • Facility CA license(s)

If you are a contracted professional services provider and have changes to report, please email KP-SCAL-Provider-Data@kp.org.

Resources for Non-Contracted Professional Services Provider

Non-Contracted Providers Interested in Participating in the Kaiser Network

Thank you for your interest in becoming a contracted provider with Southern California Kaiser Permanente Professional Services Network.

Please select the link below, you will be rerouted to our intake form to provide your individual/group information. Requests are reviewed to determine if there is a need for your specific specialty.

If the information on the form is incomplete, we will not review or retain your information.

After submitting the completed request, either of the following would apply:

If your services are not needed for the Network; your Provider/Group information will be saved on file, for 365 days from date of initial request. However, if a need is determined an assigned contact will engage by either email or phone to discuss contracting options.

Please note, submissions are not a guarantee that you have been accepted as a contracted provider, the above applies for all requests.

At this time, we are not able to provide status updates.

If you are a behavioral health provider in Southern California and would like to submit your request to participate in the Kaiser Permanente Behavioral Health Network, please send a letter of intent to Regional Behavioral Health Department at SCAL-BH-Panel@kp.org

If you are a Facility provider interested in contracting with Kaiser Permanente, please contact Network Development & Administration. They can be reached at 626 405-3240 or ndanda-providerrelations@kp.org.