Kaiser Permanente Hawaii operates differently from other insurance carriers on Headway’s platform. To be seen by a Headway provider, all HMO members must receive prior authorization for external mental health services.
Clients must be referred to Headway by Kaiser Permanente Hawaii in order to receive care through our platform. If a client has been referred to you directly through another group or outside of the Headway system, they cannot be seen through Headway.
Authorization requirement
Kaiser Permanente Hawaii requires that HMO members receive an official referral before receiving care through Headway. This referral must come from the member’s local Kaiser Permanente Mental Health Clinic, where an evaluation will be conducted. The clinic will determine the care options that are medically necessary and appropriate for the member. Whether or not the member is referred to Headway is entirely at the clinic’s discretion.
Next steps for clients without an authorization
If a client contacts you and intends to use their Kaiser Permanente Hawaii insurance, but has not yet been authorized for care through Headway:
- Cancel their upcoming appointment.
- Direct the member to contact their local Kaiser Permanente Mental Health Clinic to request an evaluation and referral to Headway. They can visit Kaiser Permanente’s mental health directory to locate a nearby clinic.
Do not proceed with appointments until Headway receives the referral from Kaiser Permanente Hawaii.
What happens after a referral is sent to Headway
Once Kaiser Permanente Hawaii authorizes a referral to Headway:
- The referral will be sent directly to Headway.
- Headway will then email the member with next steps, including:
- Instructions on how to finish setting up their Headway account.
- A unique link to book an appointment with a Headway provider.
- The member will also receive an authorization letter outlining:
- The clinic or group authorized to provide care.
- The effective date and expiration date of their coverage.
Coordinating care with Kaiser Permanente Hawaii
If your KP Hawaii patient needs services Headway doesn't provide — psychiatric medication management, group programming, substance use counseling, or a higher level of care — you can refer them back into Kaiser Permanente's Integrated Behavioral Health system using KP Hawaii's care coordination forms.
KP providers conduct their own independent assessments and make their own treatment recommendations, so a form is a referral request, not a guaranteed placement.
Which form to use
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Form A — Medication Evaluation Request
- Use when your patient needs a psychiatric medication evaluation: restarting a prior psychiatric medication, issues or side effects with a current medication (if a PCP prescribed it, have the patient contact their PCP first), a psychiatric hold, hospitalization, or ED visit in the past year, a recent suicide attempt, current or historical psychosis or bipolar disorder, an ADHD diagnostic workup (attach ASRS for 18+, Vanderbilt for under 18), or a need for residential, PHP, or IOP level of care.
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Form B — Care Coordination Request
- Use for substance use counseling, psychoeducational groups, group therapy, IOP, or cross-coverage while you're out. Some groups require a KP clinical assessment before enrollment, and enrollment is subject to clinical appropriateness and availability. Form B also lists the current KP Hawaii group offerings (IMEP, Parenting a Child with ADHD/Anxiety, Incredible Years, Written Exposure Therapy, Camp Cope A Lot, Laulima Youth IOP, adult IOP) plus the Center for Healthy Living classes and the ROSE perinatal program.
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Form C — FMLA Decision Notice
- Use when you've denied or modified an FMLA request so KP has the decision and rationale on file. Note: FMLA paperwork itself is completed by the treating therapist, not by KP — if your patient is requesting TDI, that goes to KP on Form A.
How to complete it
- Fill in the patient's name, DOB, MRN, and phone in the header, then the diagnoses, a treatment synopsis with symptom severity and screening scores (PHQ-9, GAD-7; add the C-SSRS if there's suicidality), the reason for the request, and risk factors.
- Attach your intake evaluation and most recent progress note. Confirm the three attestation boxes — including that you told your patient about the referral and that they agreed to it — and add your name, email, and phone.
- How to send it: Fax the completed form and attachments to 877-893-1865