Elective and emergency hospital admissions
All elective inpatient admissions require prior authorization. Contact Review Services for pre-authorization.
For more information about pre-authorization requirements, see Referrals and clinical review.
Emergency hospital admissions
Emergency admissions may be admitted without prior authorization if the patient is medically unstable. If the patient's emergency medical condition is stable, call EPRO 24/7/365 for authorization. See also Admission and Post Stabilization Requirement Payment Policy (PDF).
Kaiser Permanente is positioned to help Emergency Departments prior to admission with medically stable patients as well as patients who can be treated and released from the Emergency Department with non-hospital based services.
Providers can contact Kaiser Permanente through the Emergency Patient Resources & Options (EPRO) at 1-800-337-3197 (24/7 access).
How can EPRO provide assistance?
- Access to a patient's Kaiser Permanente medical records.
- Reviewing nationally accepted hospital admission criteria.
- Communicating with patients and families to explain medical necessity.
- Obtaining and coordinating non-hospital services, such as home care, home infusion, or assistance with placing a patient in a skilled nursing facility. Custodial placement is not a covered service under most health plans.
- Support to transfer patients to other facilities for continuity of care or higher level of care.