Paper claims

Kaiser Permanente strongly recommends submitting claims electronically. Electronic billing is available for primary and secondary billings for all Kaiser Permanente patients and offers the following advantages:

Decreased data errors
Reduced administrative costs
Improved cash flow
Reduced paperwork
Expedited claims processing and account reconciliation
Confirmation reports for submitted, received, and denied claims (subject to clearinghouse transaction agreements)

Claims submission must be received within one year of the date of service. Claims received more than one calendar year from the date of service will be denied as being past the timely filing deadline.

Claims must be submitted on an appropriate original CMS-1500 or UB-04 red claim form. When completing claims, refer to either CMS-1500 required fields (PDF) or UB-04 (CMS-1450) required (PDF).

For additional fields that are required for Medicare members, see general Medicare data requirements.

We enforce our policy of not accepting paper claim forms that are completely handwritten or have any handwritten notations, stamps, or stickers on them. Some exceptions apply — see the paper claim submission standards and specifications grid (PDF).

Any claims outside this policy will be rejected and returned to the provider with a letter of explanation.

Claims are generally processed within 30 days after receipt. You may check receipt status by contacting our Provider Assistance Unit at 1-888-767-4670 or by logging into the Claim Status Inquiry Padlock tool.

If you cannot submit claims electronically, send all paper claims to:

Kaiser Permanente Claims Administration
P.O. Box 30766
Salt Lake City, UT 84130-0766

Content on this page is from the provider manual | Disclaimer