Specialty Care Access Simplified for Members Enrolled in Kaiser Permanente

For Business Health Trust members enrolled in medical coverage with Kaiser Permanente, access to specialty office visits is getting easier based on feedback from members, providers and customers like you.

According to an announcement on kp.org/wa, Kaiser Permanente Washington is piloting the removal of prior authorization requirement for a select group of in-network specialty office visits, with plans to formally assess the pilot after three months than again after six months.

By doing a pilot, we can allow time to assess the impact of the change – including improved member and provider satisfaction, reduced administrative time, and increased utilization and costs in the external delivery system.

Kaiser Permanente notes that it still encourages referrals, and that it will continue to use the existing process for specialty referrals from KP providers. For perspective, the announcement notes that referrals are typically authorized at a 96 percent approval rate: “Most denials occur for out-of-network provider requests and non-covered service requests.”

For more information, you can read the full article Removing prior authorization for some specialty visits or check out the accompanying FAQ.

To learn more about the medical plans offered through Business Health Trust, visit our Health Insurance page.