Kaiser authorization request 2026

1. Click ‘Get Form’ to open the Kaiser Authorization Request in the editor.
2. Begin by entering the date at the top of the form. Next, fill in the patient's KP number, phone number, and date of birth.
3. Complete the patient’s name and address fields, ensuring all information is accurate for processing.
4. Provide details about the Primary Care Physician (PCP), including their name and phone number.
5. In the 'Referred By' section, enter the referring physician's name, specialty, and contact information.
6. Fill out the preliminary diagnosis and corresponding ICD codes as required.
7. Specify the requested service by entering details about the physician, specialty, place of service, and relevant CPT/HCPC codes.
8. Indicate any out-of-service area requests if applicable and provide a brief explanation.
9. Finally, review all entries for accuracy before submitting your request via fax as instructed on the form.

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