SECTION 4 KEY CONTACTS NORTHERN CALIFORNIA National Provider Contracting & Network Management: Provider Relations & Contracting (510) 268-5525 (510) 268-5577 Customer Service: Member Issues Member Appeals Member Claims Inquiries (800) 464-4000 (800) 777-1370 Claims Services & Authorization Questions : Claim Submissions COB Claims Status Appeal & Dispute Questions (800) 337-0115 Northern California DME Unit Attn: Manager 1950 Franklin St., 1st Fl. Oakland, California 94612 (800) 337-0115
NORTHERN CALIFORNIA DME OFFICES Facility Business Hours Main Phone / Fax DIABLO VALLEY 200 Muir Road Martinez, CA 94553 Monday-Friday 8:30 a.m. 5:30 p.m. (925) 372-1306 (925) 372-1071 Fax 925-372-1795 Main # EAST BAY 301 Eigenbrodt Way Union City, CA 94587 510-675-5555 Main # FRESNO Kaiser Permanente DME Department P.O. Box 577680 Modesto, CA 95357 GOLDEN GATE/MARIN/SONOMA DME Dept, 3rd Floor 4131 Geary Blvd. San Francisco, CA 94118 Monday-Friday 8:00 a.m. 5:30 p.m. Saturday 8:00 a.m. 5:00 p.m. 8:00 a.m. 6:00 p.m. 8:00 a.m. - 5:00 p.m. (510) 675-5565 (510) 675-5561 Fax (209) 557-1014 (209) 557-6910 Fax (415) 833-4879 (415) 833-6349 Fax 415-833-2766 Main # SACRAMENTO Kaiser Sacramento ATTN: DME Department 2025 Morse Avenue Sacramento, CA 95825 8:30 a.m.- 5:00 p.m. (916) 977-3157 (916) 486-5684 Fax 916-486-5401 Main # SAN FRANCISCO DME Dept, 3rd Floor 4131 Geary Blvd. San Francisco, CA 94118 8:00 a.m.- 5:00 p.m. (415) 833-4879 (415) 833-6349 Fax 415-833-2766 Main # SOUTH BAY 50 Great Oak San Jose, CA 95119 408-972-6139 Main # REGIONAL OFFICES 1950 Franklin Street 1st Floor Oakland, CA 94612 Monday Friday 8:30 a.m.- 5:00 p.m. (408) 574-2745 (408) 574-2749 Fax
SOUTHERN CALIFORNIA Customer Service: Member Issues Member Appeals 800-464-4000 800-777-1370 Claims Services & Authorization Questions : Electronic Data Interchange (EDI) Claims Submission EDI Lead COB Claims Status Member Claims Inquiries Appeals & Dispute Questions 866-658-2916 562-658-2916 800-390-3510 Kaiser Permanente Claims Administration Department PO Box 7004 Downey, CA 90242-7004 800-390-3510
SOUTHERN CALIFORNIA DME OFFICES KP Facility/Loc Code Business Hours Main Phone / Fax KERN COUNTY 603 3501 Stockdale Hwy 2nd Floor - DME Bakersfield, CA 93309 8:00 a.m. - 5:00 p.m. INLAND EMPIRE (Fontana 151, Riverside 500) Palm Court II Monday Friday 17284 Slover Avenue, 8:30 a.m. 5:00 p.m. Fontana, CA 92337 Saturday/Sunday 8:30 a.m. 5:00 p.m. METRO (Sunset 018, W. LA 305) 3699 Wilshire Blvd 3rd Floor 8:30 a.m. - 5:00 p.m. Los Angeles, CA 90010 ORANGE COUNTY (Anaheim 359) 2031 Orangethorpe Ave Placentia, CA 92870 8:00 a.m. - 5:00 p.m. Saturday/Sunday 8:30 a.m. - 5:00 p.m. SAN DIEGO 203 8010 Parkway Dr Admin Bldg La Mesa, CA 91942 8:30 a.m. - 5:00 p.m. TRI-CENTRAL 073 (Baldwin Park, Bellflower, South Bay) 12200 Bellflower Blvd. Downey, CA 90242 8:30 a.m. - 6:00 p.m. Saturday 8:30 a.m. - 5:00 p.m. (661) 864-3363 (DME Office) (661) 864-3368 fax (909) 609-3700 (DME Office) (909) 609-3710 fax (909) 609-3747 (Provider Line) KP Provider calls accepted until 6 PM (323) 783-1166 (DME Office) (323) 783-8480 fax (714) 279-6003 (DME Office) (714) 279-6020 fax (619) 465-7198 (DME Office) Tieline 8-293-2050 (DME Office) (619) 589-3194 fax (562) 622-4110 (DME Office) (562) 622-4304 fax VALLEYS 277 (Panorama City, Woodland Hills) & EXPANSION AREAS 13652 Cantara St., (818) 375-4266 (DME Office) 3rd Fl (818) 375-4260 fax Panorama City, CA 91405 REGIONAL OFFICES PHONE NUMBER 393 E. Walnut St. (626) 405-5000 Pasadena, CA 91188
GEORGIA Authorization: Quality Resource Management Dept. (404) 364-7320 (404) 364-7138 Customer Service: Member Issues (404) 261-2590 (404) 364-4939 (800) 255-0056 Member Appeals (888) 865-5815 Member Claims Inquiries Claims Services & Authorization Questions : COB (404) 261-2825 (404) 949-5001 Claims Status (800) 221-2131 Appeal & Dispute questions
MID-ATLANTIC STATES Authorizations: Provider Service Center (800) 810-4766 (800) 660-2019 Denial Reconsideration (888) 989-1144 Member Services: Eligibility (800) 777-7902 (301) 879-6380 Member Grievance & Appeals: Non-Medicare Plus Members (301) 468-6000 (800) 777-7902 (301) 816-6192 Medicare Plus Members Claims Services: (888) 777-5536 (301) 816-6192 COB Claims Status Electronic Submission (877) 806-7470 (800) 810-4766 (877) 806-7470
OHIO Authorizations: Authorizations (216) 529-5566 (888) 760-8880 Member Service: (216) 529-5535 Eligibility/Benefits: o Outside o Akron o Cleveland (888) 606-8759 (330) 633-8759 (216) 621-7100 (216) 621-7100 (216) 623-8765 (800) 441-9742 (Option 1) Customer Relations (216) 621-7100 (800) 686-7100 Claims Services: EDI Questions COB Claims Status (216) 623-8765 (216) 479-5550 Payments Kaiser Permanente P.O. Box 5316 Cleveland, Ohio 44101 (800) 441-9742
COLORADO Authorizations: Provider Service Center (800) 810-4766 (800) 660-2019 Denial Reconsideration (888) 989-1144 Member Services: Eligibility Claims Issues Member Claims (303) 338-3800 (800) 632-9700 Or (303) 338-3820 Colorado Springs Member Grievance & Appeals: (719) 867-2100 (888) 681-7878 Provider Claim Appeals (303) 338-3800 Kaiser Permanente Claims P.O. Box 372910 Denver, Colorado 80237 (303) 338-3600
NORTHWEST Authorizations: Authorization Questions (503) 813-4550 Member Services: Appeals/Denials Portland Area (503) 813-2000 (503) 813-4560 (503) 813-2000 Continued Services /Additional Services All Other Areas (800) 813-2000 Claim Services: Claims Submissions COB (503) 813-4332 (888) 454-4332 (503) 813-2710 TPL (503) 813-2703 (866) 374-0929 Claims Inquiries Benefits/Co-Pay Info Claim Payment Inquiries Claims Status Explanation of Benefits Member Eligibility (503) 735-2727 (866) 441-1221 Workers (503) 735-2727 Compensation (866) 441-1221 TTRICARE Medicare Primary Questions regarding (503) 813-1900 refunds & refund (800) 756-2777 requests Kaiser Permanente Northwest (Claims Administration) 500 NE Multnomah Street, Suite 100 (503) 735-2727
Portland, Oregon 97232
HAWAII Customer Service: Member Issues (808) 432-2020 (877) 447-5990 Member Appeals (808) 432-7518 (808) 432-7518 Member Claims Inquiries Claims Services: Claims Administration Department 80 Makalani Street Wailuku, Hawaii 96793