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How do I get reimbursed for care?

If you paid for emergency or urgent care1 while away from home, you’ll need to file a claim for reimbursement.Members in Georgia and Hawaii don’t have to submit a claim form, instead they need to include: a letter with medical record number (MRN) or health record number (HRN), date of service, reason for visit and the other items listed below. For help, call the Away from Home Travel line at 951-268-3900.3

Download claim forms

The following information is required for all claims:

  • itemized bills (should include date of service, services received, and cost of each item)
  • medical records (copies of original medical reports, admission notes, emergency room records, and/or consultation reports)
  • proof of payment (receipts or bank or credit card statements)

If you received emergency care outside of the United States, you’ll also need to provide:

  • proof of travel (copy of itinerary and/or airline tickets)

For instructions on submitting a claim, call Member Services.

Where do I submit my claim?

Once you’ve completed your claim form and have the documentation listed above, mail it to the Claims Administration Office for your home region.

 

Region
Mail To:
California - Northern
Kaiser Permanente
Claims Administration - NCAL
PO Box 12923
Oakland, CA 94604-2923
California - Southern
Kaiser Permanente
Claims Administration - SCAL
PO Box 7004
Downey, CA 90242-7004
Colorado
Kaiser Permanente
Claims Administration - CO
PO Box 373150
Denver, CO 80237-3150
Georgia
Kaiser Permanente
Claims Administration - GA
PO Box 370010
Denver, CO 80237-9998
Hawaii
Kaiser Permanente
Claims Administration - HI
PO Box 378021
Denver, CO 80237-9998
Mid-Atlantic States
Kaiser Permanente
Claims Administration - MAS
PO Box 371860
Denver, CO 80237-9998
Northwest
Kaiser Permanente
Claims Administration - NW
PO Box 370050
Denver, CO 80237-9998
Washington
Kaiser Permanente
Claims Administration - WA
PO Box 34585
Seattle, WA 98124-1585 

How long will it take to process my claim?

Once your claim is received, it will take approximately 45 days to process. To ensure your claim is processed as quickly as possible, please make sure you’ve included all the proper documents. If additional information is needed, processing time can take longer.

How do I check the status of my claim?

You can check the status of your claim by signing on to kp.org and visiting “Coverage & Costs.” 

What should I do if my claim is denied or incorrect?

If you feel that your claim was wrongly denied or amount received incorrect, you have the right to appeal. Please follow the appeal process described on the back of your Explanation of Benefits (EOB) form or contact Member Services.


Reviewed: May 2018
Kaiser Permanente reviewers

© 2018 Kaiser Permanente

1In-area urgent care is covered, consistent with the terms of the member’s coverage document (e.g, Evidence of Coverage), only when care is obtained from a Kaiser Permanente provider.

2The amount members are reimbursed will depend on what their copays or coinsurance are, whether they have a deductible, and other plan limitations, consistent with the terms of the member’s Evidence of Coverage or other coverage documents.

3This number can be dialed inside and outside the United States. Before the phone number, dial “001” for landlines and “+1” for mobile lines if you're outside the country. Long-distance charges may apply, and we can't accept collect calls. The phone line is closed on major holidays (New Year's Day, Easter, Memorial Day, July Fourth, Labor Day, Thanksgiving, and Christmas). It closes early the day before a holiday at 10 p.m. Pacific time (PT), and it reopens the day after a holiday at 4 a.m. PT.