Photo of a man working on a laptop

Claims Procedures

Claims Inquiry by Phone
Visiting Members

For detailed instructions and complete information about submitting claims to us, please download our the Billing and Payment Section of our Provider Manual.

Claims Inquiry by Phone

For your convenience, Kaiser Permanente has established a phone system that allows contracted practitioners/providers to call one phone number to address most issues/questions regarding Kaiser Permanente Plan protocols or Kaiser Permanente members.

For claims inquiry and issues, dial 1-866-441-1221 (toll-free) or 503-735-2727. Representatives are available to answer your questions Monday through Friday from 9:00 a.m. to 4:00 p.m. 

  • Claims Submission Questions
  • Claims Payment Inquiries
  • Claim Status
  • Explanation of Payment (EOP)
  • Referral and Authorization Questions
  • Benefits/Co-pay Information
  • Member Eligibility
  • EDI Clearinghouse Information

Back to top

Visiting Members

Learn about submitting claims for a Kaiser Permanente member that resides in another Kaiser Permanente Region.

Visiting Member Claims

If the Kaiser Permanente member that you have treated has an authorization from Kaiser Permanente NW, submit that claim to Kaiser Permanente NW Claims Administration.  Note: If another carrier is primary (e.g., Medicare), you will need to submit the claim to the primary carrier first.

If the Kaiser Permanente member that you have treated does not have an authorization from Kaiser Permanente NW, you will need to submit that claim to the member’s Kaiser Permanente Region.  Note: If another carrier is primary (e.g., Medicare), you will need to submit the claim to the primary carrier first.

Reimbursement Rates

 Providers will be reimbursed for visiting members at the same rates negotiated for all other Kaiser Permanente members.

Reimbursement for Other Services

Kaiser Permanente NW members who have paid for covered services in another service area may apply for reimbursement by submitting the receipts and a claim form to Kaiser Permanente NW Claims Administration.

Back to top