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Colorado

Important Updates

News and announcements

Important: From May 16 at 6 p.m. through May 20, due to a system upgrade, coverage information may not reflect a member’s current status. Try again on May 21.
For alternative EDI solution options, please see our Claims page section, which includes the different EDI Clearinghouses Kaiser Permanente connects with and special solutions available from Office Ally for FREE bulk and individual claim submissions to KP.
Member eligibility can be viewed through one of our self-service tools. Sign-on or Register to access KP Online Affiliate, or view member eligibility as a guest user.
Claim Status can only be obtained through one of our self-service tools. Sign-on or Register to access KP Online Affiliate, or view claim status as a guest user.
Please note that Self-Funded member claims may not be available in this self-service tool. If your inquiry is about a Self-Funded member claim, please sign on to the Self-Funded plans online tool.

HB 21 1276 Prevention of SUD- Provider Notification
HB 21 1276 Pain Diagnoses
Affiliate Provider Collaborative Meetings, Practitioners and Providers are expected to participate in Kaiser Permanente’s Quality Oversight Program. This may include collaboration or active participation on accreditation metrics, sharing of performance metrics, mitigation of performance through process improvement activities and monitoring for sustainability. For more information: KPCO Affiliate Provider Oversight Collaborative Meetings-One Pager. If interested, please let your Provider Experience Representative know.
Effective immediately-- Kaiser Permanente Colorado is discontinuing the temporary allowance for long term care (LTC) facilities to provide Part B Therapy services to Kaiser Permanente Colorado members. These services can now be coordinated with Vitality Rehabilitation and Julia Temple Outpatient Services.
Therapeutic Substitutions - Starting in August 2022, Kaiser Permanente Pharmacies will be improving the care of members who present with a prescription for a non-formulary medication. The change will allow the member to fill a formulary medication at the time of presentation and alleviate the need for the prescriber to request a medical necessity exception. More details: Southern Colorado Network Provider Communication re: Therapeutic Substitutions.
Rehab Services Referral and Authorization Process - for contracted vendors refer to the Rehab Services Referral and Authorization Process FAQ Sheet.