Our new provider portal is now live!

Welcome to our new Provider Portal! Access claims status and verify eligibility and authorization details for your patients in a single tool for enhanced care coordination.

Medicare Advantage HEDIS records collection through June 2024

Medicare Advantage providers may receive requests from Gold Kidney or our vendor, Allymar, from January through June 2024 to collect data for Healthcare Effectiveness Data and Information Set (HEDIS®) measures. The data you provide helps us monitor the quality of our members’ care and their health outcomes.

Gold Kidney Health Plan offers a full range of services to assist physicians and other providers in providing the gold standard in care and services. 

Patient Wellbeing

is the number one focus and priority for Gold Kidney and its network of trusted physicians and partners

Low to No Member Costs

for select treatments and prescriptions associated with certain chronic conditions  

Holistic, Personalized Care

including assigned member advocates, concierge services, and wellness benefits

If you think your patient could benefit from a Gold Kidney Health Plan Medicare Advantage plan,

please complete this form.


Patients residing in Gold Kidney Health Plan’s service areas can benefit from all available plan benefits regardless of if their primary care physician is in or out of network.

Authorizations & Referrals

Prior authorizations are required for a small number of services. No written referrals or authorizations are required for cardiology, cardiovascular surgeons, endocrinology, or nephrology services or providers.

Claims & Payments

Gold Kidney offers electronic claims submission through Availity. Through our relationship with Zelis, we offer Electronic Funds Transfer, which reduces provider expenses, shortens the reimbursement cycle, and streamlines provider workflows.

Gold Kidney Health Plan Network

Search here to find a provider, facility, dentist or pharmacy within our network or to learn more about covered drugsassociated with a specific plan.  

Provider Directory & Search

Search for in-network doctors, facilities or print the directory. You can search by zip code, specialty, distance, and gender.


Covered Drugs, Formulary & Forms

See which medications are covered or require pre-authorization.


Pharmacy Search & Forms

Search to find a pharmacy in our network and access pharmacy-related forms.


Resources & Forms

Find reference guides, resources, and forms that contain the most important information you will need when working with Gold Kidney members.

Model of Care Training

Take the training on how Gold Kidney and its providers will work together to enhance member health outcomes through an integrated care delivery system.

If you are in need of assistance, please feel free to contact our customer service department at 844-294-6535 or email the Provider Relations at

Become a Provider

Become a key partner in our Gold Standard of care – providing a patient-centric approach for standard Medicare Advantage patients and those with ESKD, and chronic conditions like diabetes, cardiovascular conditions, and chronic heart failure that can lead to chronic kidney disease.