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- Kaiser Permanente Supporting Documentation Cover Sheet 2007
Get Kaiser Permanente Supporting Documentation Cover Sheet 2007-2024
Ting paper documentation. Medical Record Number (MRN): Member s Name: Member s DOB Practitioner s/Provider s Name Kaiser Permanente Assigned Provider ID#: AND TIN # Date(s) of Service: Kaiser Permanente Assigned Claim Number (if kn.
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Specify FAQ
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Kaiser Permanente HealthConnect®, our comprehensive electronic health record system, integrates all aspects of care across our care delivery system.
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We serve our members using a unique business model that combines health coverage and care delivery into one coordinated experience. Unlike a traditional insurance company, we are a membership-based, prepaid, direct health care system.
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All members have the right to a second opinion. Coverage for the second opinion is for evaluation and consultation and does not guarantee that the services or treatments recommended by the physician providing the second opinion will be covered. Coverage is determined by the member's Evidence of Coverage.
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Kaiser: Kaiser has a "Believe Me" policy which allows for members to obtain the services they need from their effective date onwards even if coverage cannot be verified or the enrollment has not yet entered the Kaiser system. Any co-payments or charges would be billed ing to plan.
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Emergency room care $150 / visit $150 / visit Copayment is waived if admitted to hospital as inpatient. Emergency medical transportation $300 / trip $300 / trip None Urgent care $50 / visit $50 / visit Non-Plan providers covered when temporarily outside the service area.
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HIPAA Authorization for the Use or Disclosure of Health Information from Kaiser Permanente. Completion of this document authorizes the use and disclosure of health information about you. Failure to provide all information requested may invalidate this Authorization.
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➢ 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. After logging in: o Click Coverage & Costs o Click Health plan documents o Click Go to all bills and statements documents.
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No matter why your coverage for a treatment, service, drug, or procedure is denied, Kaiser Permanente is required to provide a written explanation for the denial, including how the denial can be appealed.
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