Kaiser permanente nursing policies and procedures 2022 pdf. This Provider Manual was created to help guide you and your staff in working with Kaiser Permanente’s various systems and procedures Kaiser Permanente Southern California GME Mission: To provide world-class education, built on the principles of Permanente Medicine, to prepare new physicians to care, to learn, to lead, and to improve the health of their patients and the communities they will serve. RESIDENT AND FELLOW (hereinafter referred to as “Resident”) POLICY AND PROCEDURE MANUAL . Do the Right Thing No set of rules or policies can provide answers to every scenario, so use the Kaiser Permanente Practitioner and Provider Quality Assurance - 6 West 2101 East Jefferson Street Rockville, MD 20852 Credentialing Files • Credentialing files remain confidential according to KPMAS policies and procedures. Kaiser Permanente Nursing: Nursing Pathways This policy and procedure cover all Kaiser Permanente Southern California faculty members, residents and fellows who have responsibility for patient care in the clinical environment. their families receive extraordinary care every time. Introduction 1. Whom to Contact with Questions The following information is provided as a quick reference to the Kaiser Permanente system. Kaiser Permanente physicians, dentists, and employees who manage the work of contractors and consultants must ensure that they abide by all applicable policies. Satisfy conditions of participation in health care programs funded by state and federal governments, the terms of our contractual arrangements, and applicable requirements associated with CMS programs, such as Medicare Part C and D program requirements. Kaiser Permanente does not make decisions regarding hiring, promoting, or terminating KAISER PERMANENTE Kaiser Permanente Provider Manual 5 Section 8: Quality Assurance and Improvement The NTN-QIC shares COE performance reports with the Regional Quality Improvement Committees for review and response. Regional Director, Mental Health Training Programs Kaiser Permanente Northern California Department of Mental Health 2022 122 Section 9: Quality Assurance and Improvement Compliance with KP policies and procedures UM statistics Quality of care indicators and provision of performance data as necessary for KP to comply with requirements of NCQA, CMS (Medicare), TJC, and other regulatory and accreditation bodies regulations, Kaiser Permanente policies, and the Principles of Responsibility. 5. Kaiser Permanente’s Nursing Vision As leaders, clinicians, researchers, innovators, and scientists, Kaiser Permanente nurses are advancing the delivery of excellent, compassionate care for our members across the continuum, and boldly transforming care to improve the Kaiser Permanente health plans around the country: Kaiser Foundation Health Plan, Inc. D. benefit limitations or Kaiser Permanente administrative policies and procedures. It is an important part of your relationship with Kaiser Permanente, but this Provider Manual does not cover all aspects of your relationship with us. -October 2022. As a valued Participating Provider, you provide services to members of the Kaiser Permanente Health Plan of the Mid-Atlantic States, Inc. MISSION . Member Service Department To verify benefits or eligibility of a Kaiser Permanente Member, contact the Member Services department in the Member’s health plan adhere to our Vendor Code of Conduct when working with Kaiser Permanente. All Kaiser Permanente physicians, dentists, and employees are expected to use For practitioners and providers of Kaiser Permanente news. MISSION Kaiser Permanente (KP), a leader in the delivery of quality medical care, has been committed to graduate medical education (GME) for over 75 years. 2 Call the Kaiser Permanente Compliance Hotline 49 Information is Proprietary to Kaiser Permanente Mental Health Training Program 1 Policy and Procedure Manual Postdoctoral Residency Programs In Clinical Psychology 2022-2023 Issued by Kathryn Wetzler PsyD Regional Director, Mental Health Training Programs Kaiser Permanente Northern California Department of Mental Health Jan 1, 2024 · California Physician and Surgeon License. KP has developed and implemented credentialing and recredentialing policies and procedures for Providers. , in Northern and Southern California and Hawaii • Kaiser Foundation Health Plan of Colorado • Kaiser Foundation Health Plan of Georgia, Inc. Kaiser Permanente’s Utilization Management (UM) policies and procedures help guide you and your team to ensure Members get the quality care and services they need, at the right locations, as per their applicable health benefits. Credentialing files are acted upon according to KPMAS policies and procedures Credentialing Process Kaiser Permanente practitioners and health care professionals make decisions about which care and services are provided based on the member’s clinical needs, the appropriateness of care and service, and existence of health plan coverage. Practitioners include, but are not limited to, MDs, DOs, oral Information is Proprietary to Kaiser Permanente Mental Health Training Program 1 Policy and Procedure Manual Doctoral Internship Programs In Clinical Psychology 2022-2023 Issued by Kathryn Wetzler, Psy. Our goal is to provide organized educational programs in a scholarly and supportive integrated managed care environment, facilitating the ethical, professional and personal development of the resident while ensuring safe and appropriate This policy and procedure cover all Kaiser Permanente Southern California faculty members, residents and fellows who have responsibility for patient care in the clinical environment. participating under HMO plans offered by the Kaiser Permanente Medical Care Program Affiliated Payors. Produced by Kaiser Foundation Health Plan of the MidAtlantic States, - Inc. The Member Resource Guide provides information on how to get care,your rights and responsibilities, guide for members with disabilities, and policies and procedures. 1 Introduction Welcome to the Kaiser Permanente Network. Kaiser Permanente Southern California GME Resident Policy and Procedure Manual Kaiser Permanente’s compliance policies and procedures. 0 The Kaiser Permanente Medical Care Program 1. 1 Report Potential Compliance Issues 49 10. Kaiser Permanente encourages open provider patient communication regarding appropriate treatment alternatives and does not restrict providers from discussing all medically necessary or appropriate care with a Kaiser Permanente Member. 1. These compliance and regulatory policies are enforced on the federal, state and/or local government, and health plan levels. Kaiser Permanente Southern California GME Mission: To provide world-class education, built on the principles of Permanente Medicine, to prepare new physicians to care, to learn, to lead, and to improve the health of their patients and the communities they will serve. C. , Nine Piedmont Center, 3495 Piedmont Road NE, Atlanta, GA 30305, 404-364-7000 • Kaiser Foundation Health Plan of . We want this relationship to work well for you, your medical support staff, and our Members. Reports on significant events are also reviewed and shared with the referring region’s Quality Assurance and Improvement Committee. COVID-19 Updates. This Provider Manual was created to help guide you and your staff in working with Kaiser Permanente’s various systems and procedures applicable to our HMO products in Northern California. Please continue to consult your Provider agreement with 7. , Nine Piedmont Center, 3495 Piedmont Road NE, Atlanta, GA 30305 • Kaiser Foundation Health Plan of the Mid 9. The credentialing, recredentialing and privileging policies and procedures approved by KP are intended to meet or exceed the managed care organization standards outlined by the NCQA. A PTL holder who receives either 12 months (US & Canadian graduates) or 24 months (international graduate) credit of Board-approved postgraduate training, taken and passed either USMLE Step 3 or COMLEX Level 3, may apply for a Physician & Surgeon’s license. This section of the Manual provides a quick Kaiser Permanente Northern California Region Residency Training Programs . If, at any time, you have a question or concern about the information outlined in this Manual, you can reach our Provider Relations Department by calling 510‐ The mission of Kaiser Permanente Northern California Graduate Medical Education (GME) is to deliver a structured and comprehensive educational program that fosters the professional and personal development of residents and fellows while ensuring the delivery of safe, high-quality, and period identified in the Agreement with Kaiser Permanente. Kaiser Permanente Southern California GME Resident Policy and Procedure Manual December 2022 1. 1 Our Commitment to Compliance Kaiser Permanente is committed to meeting the many compliance and regulatory guidelines which are implemented in the best interest of patient quality service and overall care. in partnership with the MidAtlantic Permanente Medical Group, P. During the term of such agreement, Providers are responsible for (i) maintaining copies of the Provider Manual and its updates as provided by Kaiser Permanente, (ii) providing copies of the Provider Manual to its Comply with applicable laws, regulations, policies, and procedures related to our operations. The MFA program covers: Emergency and medically necessary health care services; Pharmacy services and products; Medical supplies provided at Kaiser Permanente facilities (such as hospitals, medical centers, and medical offices), at Kaiser Permanente outpatient pharmacies, or by Kaiser Permanente providers Kaiser Permanente health plans around the country: Kaiser Foundation Health Plan, Inc. Kaiser Permanente (KP), a leader in the delivery of quality medical care, and has been committedto graduate medical education (GME) for over 75 years. You have access to many systems of care. 4 Protect Kaiser Permanente During Political Activities and When Making Political Donations 47 Know How to Get Help 48 10. For the latest updates on COVID-19 FAQs and reference guides, go to our Community Provider Portal at Northern California KPIC’s policies and procedures for the Kaiser Permanente Self-Funded Program and related administrative procedures. Reading this guide is not a substitute for reading the Principles of Responsibility, which is a condition of employment at Kaiser Permanente. Speak Up if You Have Any Questions or Concerns 48 10. xhdvc ovqqnzup ipj vqrkt iuev tzpu vviup bntw oif zjfoiu