Kern family health care prior authorization form 2025

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  1. Click ‘Get Form’ to open the kern family health care prior authorization form in the editor.
  2. Begin by selecting the type of request: Routine or Urgent/Expedited. This helps prioritize your submission.
  3. Fill in the Member Information section completely, including Patient Name, Address, KFHC Member ID#, and Date of Birth. Ensure accuracy for smooth processing.
  4. In the Facility / Provider Information section, provide details about the requesting provider, including their name, phone number, and address. Don’t forget to include their signature and date.
  5. Specify the Requested Service(s) by checking relevant boxes and entering ICD9 and CPT codes if applicable. This is crucial for identifying the services needed.
  6. Complete the Diagnosis / Clinical Problem section with detailed clinical history and attach any necessary documentation to support your request.
  7. Review all entered information for accuracy before submitting your form through our platform for processing.

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Kern Health Systems, known as Kern Family Health Care, was established in 1993 as a managed care health plan, and is the largest health plan in Kern County.
If you have any questions, please feel free to contact our Member Services department at 661.632. 1590 (in Bakersfield) or toll free at 800.391. 2000 (outside of Bakersfield) from 8:00 a.m. to 5:00 p.m., except on holidays.
How to join Kern Family Health Care Fill out a Medi-Cal Choice Form. Fill out this form to select KFHC as your health plan. Choose Kern Family Health Care on your Medi-Cal Choice Form. Confirm your enrollment.
Income Requirements for Medi-Cal 2025 Family sizeAdults Income Eligibility LimitChildren Income Eligibility Limit 1 $20,783 $40,060 2 $28,208 $54,371 3 $35,632 $68,682 4 $43,056 $82,9922 more rows
The KFHC plan offers everything covered under Medi-Cal, as well as the following: An expansive provider network. Choose from more than 800 healthcare providers, many urgent cares and 10 local hospitals. Additionally, our telehealth services enable you to speak with a specialist without having to travel far from home.
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