Provider Relations Smartsheet Auto-Reply Messenger (SAM)

Provider Relations

Smartsheet Auto-Reply Messenger (SAM)

Tax ID*

Submitter Name*

Please provide your FIRST and LAST name.

How may we help you?*

Please select from the following options:

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Demographic Change - Are you an alternative medicine provider (Chiropractor, Massage Therapist, Naturopath, or Acupuncturist)?

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Credentialing Status Inquiry: Are you an alternative medicine provider (Chiropractor, Massage Therapist, Naturopath, or Acupuncturist)?

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Contract Inquiry: Are you an alternative medicine provider (Chiropractor, Massage Therapist, Naturopath, or Acupuncturist)?

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Practitioner Add: Are you an alternative medicine provider (Chiropractor, Massage Therapist, Naturopath, or Acupuncturist)?

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Practitioner Add: Are you a Mental Health and Wellness Provider (LMHC, LMFT, PsyD, etc.)?

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Practitioner Add: Do you provide medical/surgical services in Washington State or Idaho?

Kaiser Permanente Washinton State Region offers services in the following Washington counties: Benton, Columbia, Franklin, Island, King, Kitsap, Lewis, Mason, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman, and Yakima

Services are also offered in the following Idaho counties: Latah and Kootenai.

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Practitioner Add: Do you hold a current contract directly with Kaiser Permanente's Washington State Region?

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Practitioner Term - Are you an alternative medicine provider (Chiropractor, Massage Therapist, Naturopath, or Acupuncturist)?

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Contract Term - Are you an alternative medicine provider (Chiropractor, Massage Therapist, Naturopath, or Acupuncturist)?

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Requesting a copy of an electronic remittance advice (ERA) or an explanation of benefits (EOB)?*

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General claim status for a pending claim in process?*

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How to file an appeal?*

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Other Claim Assistance?*

Member benefits, coverage, and eligibility
Claim Questions (code review, pricing dispute, diagnosis code not commonly associated with the procedure, units billed do not match, modifier listed is invalid, timely filing, no authorization obtained, quantity exceeds authorization, date of service does not fall within dates of authorization, service exceed authorization, type of service/place of service does not match, service not medically necessary)
Claim reconsideration status

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Have you contacted the Provider Assistance Unit (PAU) about your issue or question?*

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Something Else?*

Please use this comment box to email your request to the Provider Relations team and a Provider Relations Consultant will provide a response.

DO NOT SUBMIT PHI

Submitter Email Address*

Please provide your email address below so you can receive an email response to your inquiry.

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