Kern Legacy Health Plan: Provider Quick Reference Sheet

Office location: Kern Legacy Health Plan
st
1115 Truxtun Ave, 1 Floor, Bakersfield, CA 93301
661-868-3280 or 1-855-308-KLHP (5547)
Kern Medical Center is the main network provider for
Radiology, Diagnostic Laboratory, Hospital Inpatient,
Emergency Room, and most Specialty Care.
Referrals and Authorizations
Referrals and Authorizations must be submitted prior to
services being rendered. Services provided without
authorization from KLHP will not be covered.
Referral/Authorization Requirements:
 ICD-9 Diagnosis
 CPT Code
 Clinical Notes
CONTACT KLHP HOTLINE & 24/7 NURSE ADVICE LINE FOR ALL
MEMBER AND PROVIDER NEEDS
Member/Provider Services
Eligibility and Benefits
Provider Portal
Fax: 661-868-3290
Pharmacy Claims
BIN: 005947
PCN: CLAIMCR
RxGroup: #00150
Utilization Management
Authorization/Referrals
Fax: 661-868-3291
Medical Claims
Fax: 661-616-4889
Electronic Payer ID: 95213
For a list of services that do not require prior authorization
and can be performed in office, please refer to the
“No Prior Authorization” list which can be found on the
Provider Portal.
Send Claims to: HealthEdge Administrators
P.O. Box 11210
Bakersfield, CA 93389-1210
Plan Website: www.kernlegacyhp.com
Provider Portal: www.kernmdportal.com
E-mail:
[email protected]
Primary Care
Members must be assigned to a Primary Care Provider (PCP). If a member needs to consult with a specialist, the PCP will refer the
member to one within the KLHP network. All visits to a specialist are subject to plan approval.
*No Referral is required for OB/GYN and Chiropractic visits only.
Laboratory and Radiology
Members have the option of using the KMC lab location listed below.
For a list of other contracted laboratories, refer to the Provider
Directory. Radiology services must be provided by KMC.
KLHP members should NEVER be sent to a non-participating facility.
Radiology forms and guidelines can be found on our website:
www.kernlegacyhp.com
Lab and Radiology Order Requirements:
For those procedures on
 ICD-9 Diagnosis
the “No Prior
 Physician Signature
Refer KLHP Members To:
Authorization” list, the
provider may use their
existing non-KMC courier
to pick up and process
their specimens.
KMC Laboratory and Radiology
st
1700 Mount Vernon Ave. 1 Floor (D Wing)
Bakersfield, CA 93305
Laboratory Phone: 661-326-2442 Fax: 661-326-2528
Radiology Phone: 661-326-2520 Fax: 661-326-2888
Kern Legacy Draw Station (Blood and Urine Only)
st
1115 Truxtun Ave. 1 Floor
Bakersfield, CA 93301
Phone: 661-868-3280 Fax: 661-868-3270
Sagebrush Laboratory and Radiology (Routine X-Rays Only)
1111 Columbus St.
Bakersfield, CA 93305
Phone: 661-326-6588 Fax: 661-862-7617
Network Providers are available for members in outlying areas.
Updated 2/12/14 FMC for KLHP
Prescriptions
Prescriptions can be filled for a reduced or no copay at
these locations. Fax or call in prescriptions to:
KMC Campus Pharmacy
2014 College Ave.
Bakersfield, CA 93305
Phone: 661-326-6580 Refills: 661-326-2860
Fax:
661-862-7652
Sagebrush Pharmacy
1111 Columbus St.
Bakersfield, CA 93305
Phone: 661-326-6580 Refills: 661-326-6581
Fax:
661-326-6582
For Specialty & Compound Medications Only:
Komoto Pharmacy
2110 Truxtun Ave. #100
Bakersfield, CA 93301
Phone: 661-327-7524
Fax:
661-327-8793
For convenience members can utilize:
Downtown Station (Drop-off/Pick-up)
st
1115 Truxtun Ave. 1 Floor, Bakersfield, CA 93301
Phone: 661-868-3294 Fax: 661-868-3295
Drop-off prescriptions: Mon – Fri, 7:30 am -5:30 pm
Pick-up times: Mon – Fri, 9:30 am, 12:30 pm, 4:45 pm

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