Prior authorization to Kaiser Permanente

Kaiser Permanente operates as a closed-network HMO in which care is designed to be delivered by Kaiser-employed providers at Kaiser facilities. Prior authorization requests from non-Kaiser providers require documentation showing that equivalent in-network care is genuinely unavailable — without it, the request will be denied on network grounds. The referral process must be initiated by the member's Kaiser primary care provider; out-of-network specialists cannot submit PA requests independently.

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Kaiser Permanente

CommercialMedicare Advantage

PA Fax: Enter manually
PA Phone: +18005564610
Standard turnaround: 3 business days
Urgent turnaround: 72 hours

Kaiser is typically network-only. PA requests from non-Kaiser providers should go through the member services line.

Kaiser Permanente provider portal →

What you'll need

★ PortalPhonePortal preferred

☐Verify patient is eligible for out-of-network care (Kaiser is primarily in-network)
☐Confirm referring Kaiser provider has initiated the referral
☐Patient member ID
☐ICD-10 diagnosis code(s)
☐CPT procedure code(s)
☐Clinical notes from referring Kaiser provider
☐Documentation of why in-network care is unavailable (if out-of-network)

▶Common denial reasons

⚠Service available in-network — Kaiser strongly prefers in-network referrals
⚠Missing referral authorization from Kaiser primary care provider
⚠Out-of-network request without documentation of in-network unavailability
⚠Non-covered service under Kaiser plan

Verified 2026-05-20. Check payer site for current rules →

From $2.99 per submission

PA Agent requires an account so you can track submissions, record outcomes (approved/denied), and pre-fill appeals automatically. It's free to join.

You can preview the form below — sign in before generating or submitting.

⬆ Import from CSVDownload template

Submission checklist

○Provider name, NPI, practice name

○Provider phone & fax number

○Patient name, DOB, member ID

○ICD-10, diagnosis, CPT, procedure

○Clinical notes (min 50 chars · 0 entered)

○Fax destination number

○AI justification generated & reviewed

0 of 7 checks complete

Prior Authorization Request

1. Provider Information

Provider Name *

NPI * (10 digits)

Practice Name *

Provider Phone *

Provider Fax *

2. Patient & Insurance

Patient Name *

Date of Birth * (MM/DD/YYYY)

Member ID *

Group Number

💬 Patient notifications: add the patient's email below and they'll automatically receive an email when you record the insurer's decision on the tracking page — no phone call needed.

Patient Email (for outcome notifications)

Patient Phone (for future SMS notifications)

3. Clinical Details

ICD-10 Code *

Diagnosis Description *

CPT Code * (5 digits)

Procedure Description *

Urgency

4. Clinical Notes

Provider notes & supporting rationale *(min 50 chars)0/10000

5. AI Clinical Justification

PHI notice: Clicking “Generate with AI” sends clinical notes and diagnosis to OpenAI for processing. Do not include information beyond what is clinically necessary. Review your organization's policies before submitting patient data to third-party AI services.

6. Submission Method

Kaiser is typically network-only. PA requests from non-Kaiser providers should go through the member services line. Find fax number →