QUEST

We want to make our providers’ transition to our new QUEST plan as simple as possible. That means you can continue to contact the same KP Partners you do today. For any operational inquiries related to QUEST, please call 808-432-5330 (Oahu) or Toll Free at 1-800-651-2237.

If you have any other questions or concerns, please call our Customer Service Center Department at 808-432-5330 (Oahu) or Toll Free at 1-800-651-2237, (1-877-447-5990 TTY hearing/speech impaired), Monday-Friday, 7:45 a.m. to 5 p.m. or Saturday, 8 a.m. to noon.

We encourage you to utilize our Online Affiliate tool which provides self-service capabilities such as:

• Verifying member eligibility, demographics and benefits
• Referral authorization inquiry and referral request
• Access to certain member chart information
• Request access to Online Affiliate.
  

For updates to your demographic information (NPI, Address, Phone Number, etc.), please send your updates to ProviderDemographicsHawaii@kp.org.

We thank you for your participation and look forward to working with you.

Prior Authorization:
Call the Kaiser QUEST Service Coordinator at (808) 432-5330 or 1-800-651-2237
Fax: (808) 432-5260.

Referral Process is used for medical related services:
Kaiser Authorization Department for Plan Referral Phone at:
Phone: (808) 432- 5687, Fax: (808) 432-5691
Alt Fax: (808) 432-5667

Quick Reference Guide

A QUEST (Medicaid) overpayment is a payment that exceeds the allowed payment for services specified in the QUEST contract.

Overpayments may occur when a service is submitted under an incorrect patient’s name or member number, another insurance payor is identified, incorrect services are reported, or any payments received in error.

If you discover that you have received an overpayment, you must notify us in writing of the reason for the overpayment and return the overpaid amount to us within 60 calendar days after identifying the overpayment as follows:

• Include a copy of the Explanation of Payment (EOP) for each overpayment and highlight the overpaid amount.
• Enclose a check payable to Kaiser Foundation Health Plan in the amount of the overpayment.
• Provide the following information itemized for each member:
  • Reason for the overpayment refund 
  • Date overpayment was identified 
  • Patient name 
  • QUEST member number and Medical Record Number (MRN) 
  • Claim number 
  • Date of service 
  • Date of payment 
  • Overpayment amount

Mail the EOP, check and itemized information to:

Kaiser Foundation Health Plan

Attention: Hawaii Regional Claims Recovery P.O. Box 745820

Los Angeles, CA 90074-5820

Kaiser Permanente Hawaii Region’s mission is to provide high quality affordable health care services and to improve the health of our members and the communities we serve.

Delivering on this mission includes providing care in a culturally competent manner to all members including those with limited English proficiency and diverse cultural and ethnic backgrounds, disabilities, and regardless of gender, sexual orientation or gender identity.

Kaiser members have the right to receive information in a language and manner that can be easily understood. Communicating effectively with limited English speaking patients or non-English speaking patients plays a large role in ensuring the quality of and compliance with care provided to members.

The Kaiser Permanente Hawaii Region’s Cultural Competency Plan is available to providers upon request at no charge.

Cultural Competency Plan

Claims Customer Service

Contact Claims Customer Service for general claims information and billing questions, claim payment status, claims submission.

Monday – Friday 8:00 am – 4:30 pm
Oahu: 808-432-5330
Toll Free : 1-800-651-2237
Fax: 1-808-432-5433

Customer Service

Contact Customer Service for general eligibility questions and benefit verification.

Monday – Friday 7:45 am – 5:00 pm
Saturday – 8 am – 12 pm
Oahu 1-808-432-5330
Toll Free 1-800-651-2237
Hearing or Speech Impaired Toll Free:1-877-447-5990 (TTY)
Fax: 1-808-432-5300

Emergency Hotline

For emergency transfers to Kaiser Permanente Moanalua Medical Center & routine transfers after clinic hours:

(808)-643-6364
24 hours

QUEST Service Coordinator

Phone: 808-432-5330 (Oahu) or 1-800-651-2237 (Toll Free)
Fax: 1-808-432-5260

• April 2024 Newsletter
• May 2023 Newsletter

• June 2021 Newsletter
• April 2020 Newsletter

We are providing training sessions through WebEx, group trainings, and in-person education and training sessions to all contracted Kaiser Permanente Providers. Please review the training calendar for dates, times and locations. If you are interested in attending a training session or have a question regarding the calendar, please refer to the Contact List.

CMS Claim Form*

Code of Ethical Conduct - Kaiser Permanentes Principles of Responsibility

Compliance with Deficit Reduction Act Requirements Policy

Electronic Visit Verification – Provider Welcome Letter

Electronic Visit Verification – HCPCS Codes & Modifiers Lists

Fraud, Waste, and Abuse Control Policy

HHS Announces Enhanced Provider Portal Relief Fund Payments

Member Grievances and Appeals Quick Reference Guide* 

Member Rights and Responsibilities Quick Reference Guide*

New Provider Orientation*

Prevention Detection and Reporting Fraud, Waste, and Abuse (FWA)

Prior Authorization Quick Reference Guide*

Provider Claims Submission Quick Reference Guide*

Provider Education & Training: Clinical Providers/MDs

QUEST Provider Education and Training Handout*

Webcast HRSA COVID 19 Medicaid and CHIP Program