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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 $1.99 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.

Submission checklist

○Your name, date of birth, member ID

○Your situation described (min 50 chars · 0 entered)

○Insurer fax number

○AI appeal letter generated & reviewed

0 of 4 checks complete

Prior Authorization Request

1. Your Doctor's Information(optional — helps strengthen your appeal)

Doctor Name

NPI (10 digits)

Practice / Clinic Name

Doctor Phone

Doctor Fax

2. Your Information & Insurance

Patient Name *

Date of Birth * (MM/DD/YYYY)

Member ID *

Group Number

3. Clinical Details(optional — include if known)

ICD-10 Code (if known)

Diagnosis (if known)

CPT Code (if known)

Denied Treatment / Procedure

Urgency

4. Your Medical Situation

Describe your situation in your own words *(min 50 chars)0/10000

Explain why you need this treatment, what your doctor has recommended, and what happened when the insurer denied it. The more detail you provide, the stronger your appeal.

5. AI Appeal Letter

Privacy notice: Clicking “Generate with AI” sends your description to OpenAI to draft your appeal letter. Do not include sensitive information beyond what is medically relevant.

6. Submission Method

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