Authorizations

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View authorizations

Download our authorization policies* to learn more about our utilization management and authorizations process, including:

• the role of the Provider Service Center, our centralized authorization and referral department
• referral policies and procedures
• hospital and facility admissions
• case management
• denials and appeals

We provide medical coverage policies - referral guidelines as a reference for health care professionals within the Kaiser Permanente Medical Care Program. The Kaiser Permanente Mid-Atlantic States medical coverage policies may provide details about referring patients for treatment, including the following:

• diagnosis
• indications
• contraindications
• measures prior to referral
• clinical indications for referral
• optional approaches

If you would like to receive a hard copy of the Medical Coverage Policy, UM criteria/protocol or Affirmation Statement, please contact the Utilization Management Operations Center at 1-800-810-4766 and follow the prompts.