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  • Kaiser Oregon Group Employee Enrollment Form

Get Kaiser Oregon Group Employee Enrollment Form

T. 500 NE Multnomah St., Ste. 100, Portland, OR 97232 See instructions on pages 2 3 before completing this form. This section to be completed by the employer. Company name* Effective date of coverage* Group no.* Medical subgroup no. PART I: Billgroup Dental subgroup no. / / Date of hire* / / Billgroup PART II: Enrollment/change reason complete if existing group* (Please check one.) Event date New group New hire Newborn Loss of coverage Part-.

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Contact support

To locate Kaiser Permanente pharmacies in Oregon and SW Washington, search the pharmacy directory. To request medical advice and appointments, call 1-800-813-2000 (TTY 711). For questions or assistance call Customer Service at 1-866-616-0047 (TTY 711) For technical assistance, visit kp.org/supportcenter.

Contact 866-921-5310 (toll free) for instructions on submitting electronic claims. You may now submit appeals online via the Online Affiliate portal. Sign on or Register to access KP Online Affiliate and start using this feature today.

The best way to edit HealthPlan Services (Payor ID # 59143) online.

Please contact our Member Service Call Center at 1-800-788-0710 or visit your local Member Services office to obtain an Authorized Representative form to submit to us.

Request an Explanation of Benefits (EOB) document and Professional Demand Bill from Kaiser. ➢ To obtain the EOB and Professional Demand Bill, contact Kaiser Permanente Patient Financial Services (PFS) at 1-800-498-2748. ➢ EOBs can also be downloaded from kp.org.

Kaiser Permanente's payer ID number is 94134.

The group number for Kaiser Northern CA is 39044.

Kaiser Permanente Claims and Referral Department PO Box 373150 Denver, CO 80237-6970. Provides information related to KPIC Self-Funded claims payment for services provided. All claims should be sent electronically, if possible.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232