Having comprehensive health coverage is essential for accessing the care you need while avoiding financially burdensome medical bills. For Kaiser Permanente members, fully utilizing your plan’s offerings requires familiarity with administrative systems like KPschedule. This article will provide an in-depth explainer of KPschedule and how it relates to health plan benefits, time and attendance reporting, provider authorizations, staff scheduling, and more.
Brief Background on Kaiser Permanente
Kaiser Permanente (KP) is one of the nation’s largest not-for-profit health plans, serving over 12 million members. It operates 39 hospitals and over 800 medical offices across several states. KP is structured as an integrated system where all care is delivered by providers employed by the health plan. This allows for efficient coordination of care.
Understanding the details of your specific KP health coverage is key to getting the most out of your plan. That’s where gaining familiarity with tools like KPschedule comes in handy.
Summary of Benefits and Coverage Documents
The Importance of SBC Documents
Summary of Benefits and Coverage (SBC) documents outline key details of your KP health plan, including covered services, cost-sharing details, provider networks, and more. Reviewing your plan’s SBC helps you understand what care options are accessible and how much you’ll pay.
These standardized documents let you easily compare plans when shopping for coverage. SBCs summarize key exclusions, limitations, and examples of costs you could incur using the plan. This transparency helps you select the best plan for your needs and budget.
Accessing SBC Documents
Members can access SBC documents for their KP plan in a few ways:
- Log in to your KPschedule account at kp.org and navigate to “Coverage & Costs” then click “Documents” to view and download SBCs.
- Visit kp.org/sbc select your state and plan to access SBC documents without logging in.
- Call member services and request paper copies of your plan’s SBC documents.
Be sure to review your SBC annually at open enrollment or whenever changes occur to understand updated coverage details.
Pay Codes in KPschedule
Overview of Pay Codes
Keeping track of time and compensation for KP employees relies on an organized system of pay codes configured in KPschedule.
Pay codes are earnings codes, shift differentials, overtime codes, paid time off banks, and other labels used to represent categories of pay and benefits. Properly configured pay codes feed into payroll and determine total earnings.
Setting Up Pay Codes
Department admins can log into KPschedule to build customized pay codes reflecting offerings like incentives, differentials, stipends, and more. Unique codes can be tied to rules dictating eligibility, accrual rates, and usage limits.
IT teams activate new pay codes so they correctly integrate with payroll. Workers can then accurately log hours against the right categories for automated earnings sorting.
User-Defined Categories
KPschedule enables departments to create user-defined categories supplementing system-wide codes. These categories allow tagging earnings to department Cost Center IDs.
Custom categories help track and allocate pay more granularly while consolidating everything under broad system-defined codes for payroll. This added flexibility improves cost tracking and budgeting.
Time and Attendance Reporting
Time Card Reports
The Time Card Report in KPschedule provides convenient centralized access to employee time cards. Users can view, adjust, approve, and process time entered across pay categories.
Configure filtering to display subsets of staff. Choose customizable date ranges or pay periods for time card data. Easily audit, update, and sign off on hours logged by individuals or departments.
Displaying Pay Categories
Optional Time Card Screen views display essential pay code data alongside time cards. The “Pay Categories” tab shows accrued, taken, and available hours per earned leave category.
The “Totals” tab displays cumulative hours, shifts, and estimated earnings per pay code. Cross-reference with time entries for added transparency.
These configurable views improve managing benefit time allotments alongside logged work hours.
Dental Benefits Available from Kaiser Permanente
Dental Plan Options
KP members can enroll in dental plans offering routine, basic, and major services both in-network or out-of-network. Plans differ by geographic region but often include:
- KP Dental Optimum Plan: Comprehensive coverage including orthodontics
- KP Dental Basic Plan: Preventive and basic services
- KP Dental Physician Fee Plan: Coverage for referrals to specialty care
Review SBCs when selecting plans to understand copays, coinsurance, exclusions, and limitations.
Enrolling in KP Dental Plans
Use KPschedule to manage dental plan enrollment:
- New members can enroll via kp.org when first signing up
- Existing members can use KPschedule to enroll or switch plans annually during open enrollment
Contact member services for qualifying life events allowing off-cycle dental plan changes through KPschedule.
Finding Participating Dental Providers
Check kp.org/dentist to search for in-network dentists near you by location, specialty, gender, languages spoken, and more. You can preview details like office hours, patient experience ratings, and plan acceptance.
Getting Chiropractor Care Authorization
Searching for a Chiropractor
To find an approved chiropractor using your KP coverage:
- Go to kp.org/chirosearch on KPschedule
- Enter your location to view in-network chiropractors nearby
- Preview chiropractor details like credentials, specialty, accepted plans, reviews, and more
- Choose a highly-rated chiropractor close by
Getting Authorization
Visits to an out-of-network chiropractor require prior authorization through KPschedule before getting covered care.
To get approval:
- Ask your selected chiropractor to submit a treatment plan and authorization request via KPschedule
- Make sure to provide current coverage details
- Check KPschedule for the status of your authorization request
Once approved, you can schedule appointments knowing you’ll pay only copays or coinsurance.
Paying for Chiropractor Services
When checking in for appointments, provide health plan details to access negotiated rates. Otherwise, you may incur higher out-of-network costs.
After visits, pay any copays or coinsurance owed. Track payments and visits by checking explanations of benefits via KPschedule. This allows for reconciling billing statements.
Staffing and Scheduling System
Overview of KP Staff Scheduling
The KPschedule application includes robust tools for managing healthcare staff scheduling. The system lets administrators configure shift templates, assign employee roles, build schedules spanning locations and departments, and more.
Workers can view schedules, pick up open shifts, bid for time off, trade with colleagues, and request schedule changes. Centralized scheduling data feeds into payroll and attendance tracking.
Accessing KPschedule Staff Scheduling
Employees can log into KPschedule using their health record number and password at kp.org or via the health plan mobile app.
Navigate to “My Schedule” to view assigned upcoming shifts. Review schedules published up to six weeks out spanning multiple departments or locations in a consolidated view.
Admins access additional tools for building and adjusting schedules while analyzing gaps in coverage. Configure schedule settings, assignments, workflows and more.
Key Takeaways
Getting the most from Kaiser Permanente health coverage requires understanding administrative systems like KPschedule containing your plans’ coverage details, provider networks, authorizations, staff schedules, payroll categories, and more.
Key highlights include:
- Review Summary of Benefits and Coverage documents via KPschedule to understand your plans’ offered services, costs, and restrictions
- Departments use KPschedule to configure personalized pay codes integrated with payroll for accurate earnings
- Time and Attendance Reports in KPschedule display consolidated employee time card data for verification
- Use KPschedule to enroll in dental plans and search for participating in-network dentists
- Obtain authorizations for out-of-network chiropractor care using KPschedule tools
- Access staff schedules, shift trades, and open assignments in KPschedule
With a strong grasp of KPsystems like KPschedule, you can access care confidently and hassle-free. Review your plans’ offerings and administrative tools annually and when changes occur to stay up to date. Reach out with any other questions.
