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Forms & Resources

lady discussing form

Please Note: This content applies to the Kaiser Permanente’s Neighbor Island Networks delivery system on the islands of Kauai, Molokai and Lanai only.

Kaiser Permanente Authorization and Neighbor Island Referral form

Personal History Sheet

  • Office Ally Payer ID - 94123 (360) 975-7000

  • Provider Monthly Training
    • Monthly Provider OLA Training: every 2nd Thurs of each month from 10:00AM-11:00AM HT
    • BH After Office Hours: every 3rd Tuesday of each month from 10AM-11AM HT
    • HCBS After Office Hours: every 2nd and 4th Wednesday of each month from 12:00PM-1:00PM HT

  • Relay Health Payer ID = RH011
     

Training Materials

The resources below are intended for providers who are contracted with Kaiser Permanente Hawaii region. They provide an introduction to how processes work within our organization and include information about how to best serve our members.

Video: EOP Account Summary

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Video: EOP Recoupment Detail Report

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Training Calendar

Fridays 9 - 11am
711 Kapiolani Blvd, Ste 110, Honolulu

Paid Parking – across the street parking garage

Dates:

  • 1/19/2024, 1/26/24,
  • 2/2/24, 2/9/24, 2/23/24,
  • 3/1/24, 3/8/24, 3/15/24, 3/22/24,
  • 4/5/24, 4/12/24, 4/19/24, 4/26/24,
  • 5/3/24, 5/10/24, 5/17/24, 5/31/24,
  • 6/7/24, 6/14/24, 6/21/24, 6/28/24,
  • 7/12/24, 7/19/24, 7/26/24,
  • 8/2/24, 8/9/24, 8/16/24, 8/23/24, 8/30/24,
  • 9/6/24, 9/13/24, 9/20/24, 9/27/24,
  • 10/4/24, 10/11/24, 10/18/24, 10/25/24,
  • 11/1/24, 11/8/24, 11/15/24, 11/22/24,
  • 12/6/24, 12/13/24, 12/20/24.

Behavioral Health (BH) Office Hours are held every 3rd Tuesday of the month from 10am-11am

Monthly Provider Trainings are held every second Thursday of each month

   
January 11, 2024 July 11, 2024
February 8, 2024 August 8, 2024
March 14, 2024 September 12, 2024
April 11, 2024 October 10, 2024
May 9, 2024 November 14, 2024
June 13, 2024 December 12, 2024