Q: What should I do if the beneficiary does not present their medical card at their appointment?
If the beneficiary does not present his or her card at the time of the appointment, you have the option to have the beneficiary pay out of pocket for the services being rendered. However, since some of the beneficiaries might not have the money at the time of service, you can verify the beneficiary's eligibility through either the Automated Voice Response System (AVRS), KMAP Customer Service at 1-800-933-6593, or the KMAP website at https://www.kmap-state-ks.us.
Q: I received a bill because I did not get a referral. Do I need to pay this bill?
If you have a primary care doctor a referral may be required for treatment provided by another doctor. If you receive a bill for a service, you should contact the provider, your KanCare plan, or the KMAP Customer Service if you are not assigned to a plan to look at a specific bill.
Q: I received a bill because I didn't present the medical card at the time of service. Do I need to pay this bill?
The provider is allowed to charge you for a service if you failed to present your medical card at the time you received the service. However, you may wish to contact the provider about the situation.
My doctor told me that he would accept the Kansas Medical Card. Well, I just received a bill from my doctor because his normal rate is more that what KMAP pays. Do I have to pay this bill?
If the provider agreed to accept the card, then he must accept the rate that we pay. He can bill you for copayments tied to the services, but cannot bill you to make up the difference in the rate. Do not ignore the bill. Contact the provider to discuss the bill. If you need further assistance with this issue, contact KMAP at 1-800-766-9012.
Will it be faster to do an adjustment online? Can adjustments be done for both underpayments and overpayments? :
Online adjustments, like electronic claims, process much quicker than they would if submitted on paper. You will be able to submit adjustments for both underpayments and overpayments. We encourage providers to take advantage of this enhanced functionality when needing to submit an adjustment to a previously paid claim. :
How can I find out why my claims are denying? :
On your remittance advice (RA), KMAP provides EOBs (explanation of benefits) which help to explain why your claim has denied. The denial reasons are also explained on the KMAP website when you look at a denied claim after you have logged on. For a list of common EOBs and some potential fixes, please refer to the Common Denial EOBs section of the FAQs. :
How long does it take for a claim to process? :
A clean paper claim can take up to eight days to process. An electronically submitted claim through a clearinghouse or PES can take a few hours, as long as there are no reasons for it to suspend. A claim submitted through the KMAP website can process within 30 seconds.br/>
Q: Do I have to fill out an EDI application?
If you are an active enrolled provider with KMAP, you must fill out an application unless you will only be using the website or clearinghouse. The application is used when you wish to submit files directly to EDI for compliance.
Q: How do I know if KMAP has authorized my clearinghouse or billing agent?
Contact the EDI department at LOC-KSXIX-EDIKMAP@groups.ext.hpe.com or 1-800-933-6593, option 4. Provide them with the name or submitting number of your clearinghouse or billing agent.
Q: Can I file everything to KMAP electronically?
There might be some instances when you would have to send us documentation to support your claim (for example, EOB or medical necessity). If you use the KMAP website, you can use the hard copy attachment and submit claims electronically. If you use a clearinghouse or batch billing software, you would not be able to file these types of claims electronically.
Q: Can I use a clearinghouse to submit my claims electronically?
Yes, you can. The clearinghouse you choose to work with will need to test for Health Insurance Portability and Accountability Act (HIPAA) compliance with our EDI team before you can begin using them for your transactions.
Q: I have software which will allow for me to submit batches of claims. Is this acceptable to use with KMAP?
Yes, you can potentially use this software for batch submission. Contact the EDI team at 1-800-933-6593, option 4, for instructions on how to begin testing for HIPAA compliance.
Q: What are the advantages to filing electronically?
One of the big advantages is the speed at which the claim processes. Electronic claims can process within hours, whereas paper claims can take (on average) eight days from start to finish. Some other advantages are that you would save money on ink for your printer, postage, and paper.
Q: What do I need to do to be able to submit claims electronically to KMAP?
Contact the EDI team at 1-800-933-6593, option 4. They will be able to tell you the steps to take to begin testing with KMAP for HIPAA compliance on your electronic transmissions.
Q: Can I submit paper and electronic at the same time?
Yes, you can. However, you do not want to submit the same claim electronically and on paper at the same time.
Q: Do I have to do EDI?
No. You can still submit on paper. EDI is preferred because claims can be paid faster (hours instead of days) and potential processing errors are minimized.
Q: Do I have to pay to submit claims electronically?
No. EDI offers two solutions for submission of claims: Direct Data Entry (DDE) on the website or PES (Provider Electronic Solutions) software. You can also use internal software, a software vendor, or a clearinghouse that has passed authorization with KMAP.
Q: What is EDI?
EDI stands for Electronic Data Interchange. This is the method you can use to submit claims electronically through either PES (Provider Electronic Solutions), a clearinghouse, or software you use.
Q: Why do I need to test if I have been submitting electronically?
HIPAA regulations require that all EDI transactions are HIPAA compliant.
Q: Which HIPAA transactions will KMAP support?
Refer to the HIPAA Companion Guides on the HIPAA Companion Guides page of the KMAP website.
Q: How do I fix my claim which denied for EOB 0003 - Beneficiary ineligible for all or a portion of the service dates billed?
This edit posts when the beneficiary is not eligible for the date of service billed on the claim. If this is the case, please verify that you have proof of coverage for the beneficiary for the dates you are billing. Also verify that the dates of service on your claim are correct. If the beneficiary was not eligible for the dates indicated on the claim, the beneficiary is responsible for the charges.
Q: How do I fix my claim which denied for EOB 0015 - Duplicate of claim paid?
This edit posts if the detail has paid and the same services are billed again for a beneficiary. Please refer to previous payments and RAs to find the previous payment.
Q: How do I fix my claim which denied for EOB 0032 - Beneficiary ID number incorrect or missing. Use ID card to correct claim form and resubmit?
This edit posts if the beneficiary ID number does not match the beneficiary ID in MMIS. Verify that the ID number and name are correct. The easiest way to fix this claim is to access the claim through the claim inquiry function on the KMAP website, remove the beneficiary ID from the claim, move out of the field (this causes a box to appear stating """"""This beneficiary ID is not on file""""""), enter the ID number, and move back out of the field. The system auto-populates the name and date of birth associated with the ID number indicated.
Q: How do I fix my claim which denied for EOB 0183 - Denied. This claim is beyond 12 months from the date of service and cannot be paid. Refer to section 5100 of your Kansas Medical Assistance Program provider manual for more information?
This edit posts if the dates of service are more than 12 months old and there is not proof of timely filing on the claim. If you have proof of timely filing, resubmit the claim with the appropriate information. If you do not have proof of timely filing, your claim will be denied and you will have to write off the charges.
Q: How do I fix my claim which denied for EOB 0185 - Denied. Bill beneficiary's other insurance first?
This edit posts if KMAP has another TPL policy on file for this beneficiary. Please verify the TPL information on the beneficiary's eligibility and resubmit with the appropriate TPL payment information.
Q: How do I fix my claim which denied for EOB 0342 - Detail denied. Procedure code is noncovered for this provider type and specialty?
This edit posts if your provider type and specialty are not covered for the procedure code billed. Please check your coding.
Q: How do I fix my claim which denied for EOB 0451 - Detail denied. Physicians not in a group practice must use the same performing provider number as the billing provider?
This edit posts when the claim indicates a group number as the performing or rendering provider. You can correct this on the KMAP website by logging on, finding the claim, and making the appropriate changes to the performing provider field on the claim.
Q: How do I fix my claim which denied for EOB 0818 - Claim denied. The sum of other insurance, noncovered charges, and/or other party liability exceeds the total amount billed/allowed?
This edit posts when the payments of other insurance are more than the amount which is being billed to KMAP. Verify that all information is correct and resubmit the claim to KMAP for processing.
Q: How do I fix my claim which denied for EOB 1455 - The beneficiary birth date is missing, invalid, or disagree?
This edit posts if the date of birth on the claim does not match the date of birth in MMIS. The easiest way to fix this claim is to access the claim through the claim inquiry function on the KMAP website, remove the beneficiary ID from the claim, move out of the field (a box appears stating """"""This beneficiary ID is not on file""""""), enter the ID number on the claim, and move out of the field. The system auto-populates the name and date of birth which is associated with the ID number indicated.
Q: For anesthesia, is the Relative Value (Column I) multiplied by Conv/Adj (Column J) to get the expected allowed amount?
The allowed amount equals the anesthesia minutes divided by 15 plus the relative value multiplied by the conversion factor. Example: 60 (anesthesia minutes) divided by 15 = 4; 4 + 3 (relative value) = 7; 7 X $14.78 (conversion factor) = $103.46 (payment)
Q: Is the max fee (Column H) applied to the % adjustment (Column K) to get the expected allowed amount?
Yes, the max fee is applied to the % adjustment to get the expected allowed amount.
Q: When max fee with adjustment is noted, the max fee is applied to the adjustment. If the allowed amount is 1 unit with adjustment, does only the first unit apply to the adjustment and the remaining units billed do not have the % adjustment applied?
No. Regardless of the units billed, only 1 unit will be paid. The unit will be priced by applying the percentage of the max fee rate for the 1 unit.
Q: How can I get a copy of the Fee Schedule?
There are current copies of the Fee Schedule available online at https://www.kmap-state-ks.us/Provider/PRICING/Disclaimer.asp?goto=/Provider/PRICING/ScheduleList.asp. Scroll to the bottom of the window and click Accept. The KMAP Fee Schedules window displays. There are two boxes with drop-down menus from which to select. From the Program drop-down list, you can select TXIX (title 19), QMB, and MediKan. Once you have selected one of those options, the Select Rate Type drop-down becomes available. Select the rate type which best describes the services being rendered. Depending on which selections you make, there will be at least a current version and possibly historical versions as well.
If you do not have access to the KMAP website, you may contact the KMAP Customer Service Center and request a fee schedule to be sent to your office on CD for a fee.
Q: How do I know which program to select?
Look at the benefit plan for which the beneficiary is eligible. If you do not see the beneficiary's plan listed on the website, select TXIX. This will show you the max fee allowed.
Q: If a beneficiary is assigned to a waiver program, how detailed will the beneficiary's eligibility screen display the waiver program?
The beneficiary's eligibility screen lists the Program (e.g. HCBS Physical Disability), Effective Date, and End Date in the eligibility section and the client obligation (patient liability) in the LTC box above the eligibility screen.
Q: Are there guides available to assist with HIPAA compliance?
The fiscal agent maintains a series of Companion Guides to document how local codes will be used in conjunction with the national formats.
Q: How will KDHE-DHCF and the fiscal agent notify providers about the HIPAA changes?
This KMAP website is the primary communication tool to providers. The fiscal agent provides bulletins and global/RA banner messages to supply providers with valuable information regarding HIPAA/EDI as needed.
Q: I do not currently file HIPAA-compliant electronic claims. What do I need to do?
If you do not file electronically at all, you should visit the EDI section to determine which claims submission option is best for you.
If you file electronically through a clearinghouse, vendor, or billing agency (send your data to someone who in turn sends it to the EDI department), you need to contact the entity and ensure they have tested transactions with us. You can contact the EDI department and give us the entity's contact information by telephone at 1-800-933-6593, option 4#, or send a request for us to test with the entity by email.
If you plan to use PES (free PC software provided by the fiscal agent), you need to schedule testing of your first claims submission by telephone at 1-800-933-6593, then option 4#, or by email.
Q: I only employ a handful of staff members. Does HIPAA really apply to me?
HIPAA applies to every medical provider, large or small. It is important for each provider (and other healthcare entities) to review thoroughly the new regulations to determine how HIPAA applies to his or her own unique business needs.
Q: If I only submit paper claims, do I have to change anything?
You can continue to submit paper claims; however, you need to review any changes to KMAP policy that are a direct result of HIPAA code changes to determine if they impact your billing practices.
Q: What should I be doing to become HIPAA compliant?
Each provider is individually responsible for ensuring their respective organization's operations support HIPAA regulations. If you submit claims electronically, you should contact your billing service, clearinghouse, software vendor, or internal IT department to ensure your data meets the HIPAA national formats. If you have questions about sending electronic claims or are ready to test a transaction, call the EDI team at 1-800-933-6593 option 4#, or send an email request.
Q: Where can I get more information about HIPAA?
The Centers for Medicare & Medicaid Services (CMS) website provides more information about the federal law.
Q: Can everyone in a provider's location have the same password when there are 150 - 200 employees that will be given access?
Yes; however, the fiscal agent recommends that each user has a unique password. The password, which is case sensitive and must be eight characters in length, must start with a letter and contain at least two numbers. Use the following password guidelines to reduce unauthorized access:
Do not use any character more than twice.
Do not use alphabetic characters only.
Do not use easily recognizable passwords incorporating things such as """"password,"""" your name, birth dates, names of children, and so forth.
Q: How many years of claim history are available? Can I use the Internet to fix an old claim that I filed on paper?
We maintain five years of history. You can use the Internet to inquire on any of your claims; however, you can only adjust claims up to two years old through the Internet. Claim adjustments for dates of services older than two years from the current date require approval and must be submitted on paper.
Q: How often do passwords change? Can they be flip flopped every other time?
Passwords expire every 30 days and must be changed. We recommend that passwords not be reused.
Q: Can I adjust claims using the KMAP website?
Yes, you can. Adjusting a claim via the KMAP website allows for it to process quickly. It is important to remember that if there were any attachments with the original claim, they must be submitted again if they are necessary for the claim to process. If this is the case, you can use the hard copy attachment portion of the claim to submit these documents.
Q: How do I get my user name and password for the KMAP website?
When you first enrolled as a provider, you should have received a letter with information regarding how to log on to the KMAP website. This letter included a PIN. If you have that letter, you can log on by going to the login portion of the website (https://www.kmap-state-ks.us/provider/security/logon.asp). In the """"First time here"""" portion, enter your provider ID and location (for example, 123456789A) in the Log On ID field and then enter your PIN. Your PIN is case sensitive, so pay careful attention to how you enter the information. If you have problems with this process or do not have the letter, please contact the KMAP Customer Service Center at 1-800-933-6593.
Q: Is there a time when I could not adjust a claim using the KMAP website?
If the claim is more than two years old, you cannot adjust it using the website. These will have to be filed on paper. You also cannot adjust a claim using the KMAP website if it is more than 12 months old AND you are changing the beneficiary ID, billed amount, or dates of service, or you are adding details.
Q: Can I access my RAs via the KMAP website?
You can potentially access your RAs through the KMAP website, if you have asked to receive them electronically. On the main menu after you have logged on, there are links to your available RAs. These links display only the most recent RAs. Through the Trade Files option, you can access as many RAs as are avaiable to you, depending on when you signed up for electronic RAs.
Q: Do I need to enter the decimal point when entering diagnosis codes?
When entering the diagnosis codes on a claim via the KMAP website, do not enter the decimal point. If you enter the decimal point, the website indicates that the diganosis entered is not valid or not on file. Just enter the numbers for the diagnosis code.
Q: Does an Internet submitted claim receive an ICN immediately?
As soon as you click Submit, the claim is submitted to MMIS for processing. Because it is an immediate submission, it is assigned an ICN immediately. If it is an original claim (not an adjustment or void), the ICN starts with a 60. If the claim is an adjustment or a void, it starts with a 59.
Q: Does the Beneficiary Eligibility window display the eyeglass dispensing date?
Yes. When looking at this information, you might see a """"P"""" with the date, which indicates this was a partial dispensing of glasses. This could mean that the beneficiary either received new frames or new lenses.
Q: Does the system have the capability to limit the number of claims that will display when an inquiry is submitted?
You can limit the claim inquiry search by setting specific parameters at the search window. You can search by Beneficiary ID, Status (Any Status, Paid, Denied, or Suspended), Patient Account, Date Type, or ICN.
Q: How can I obtain a copy of my provider manual and bulletins?
You can view your provider manual and bulletins on the KMAP website (https://www.kmap-state-ks.us). If you do not have Internet access, you can contact the KMAP Customer Service Center at 1-800-933-6593 and request a paper copy of your provider manual.
Q: How can I view my electronic RAs?
To view an electronic copy of your RA, you need software that translates it for you.
Q: The manuals online are very large. Is there an easy way to find the information I need?
The provider manuals and bulletins all open in Adobe Reader. This program has a feature that allows for you to search for specific words or phrases quickly. Press the Ctrl and F keys at the same time to display the Find box, and the search feature prompts you to enter the word or phrase you want to look up. Adobe will find each time your word or phrase appears in the document.
Q: We bill for several providers. Will we have to log on to the website separately for each provider we bill for?
Each individual provider will have its own log on ID and password. However, each individual member of your billing staff can be set up as a clerk and granted access to each super-user account. With this access, the Switch Provider Number option displays at the top of the main menu after the super-user logs on. Each clerk can be granted access to as many provider IDs as needed.
Q: What happens if the system times out while I am entering a claim?
The session times out after 20 minutes of inactivity. If the system times out while you are in the middle of a claim, no information transmits or saves. You will need to begin entering the claim again. This safeguard avoids any potential HIPAA violations.
Q: What is the best way to get current information regarding a patient's spenddown?
For a real-time update to the patient's spenddown amount, go to the eligibility portion of the secure KMAP website and enter the patient's ID number. The remaining spenddown amount displays on the beneficiary's eligibility portion. That spenddown amount is accurate as of the moment you are checking the eligibility.
Q: Where can I get more information about a beneficiary's third-party liability (TPL)?
There is a TPL section on the Beneficiary Eligibility window. The insurance company's name is a link which displays its name, carrier code, and address.
Q: Where does Title XXI elgibility information display on the Beneficiary Eligibility window?
Title XXI eligibility information displays in the Eligibility section of the Beneficiary Eligibility window, after the KBH and LTC information. If the beneficiary is enrolled with HealthWave 19 or 21, the MCO is listed under the Managed Care section of the Beneficiary Eligibility window.
Q: Does the website accept date spans when billing?
Q: How do you delete diagnosis codes from the claim entry form?
Highlight the field and delete by clicking the """"X"""" button.
Q: How will clerks be set up to view information for every clinic, doctor, or facility for which they bill?
Each provider/service location will receive an Internet PIN. You will need to create IDs for each staff member who needs an ID. Once all IDs are created, you will need to grant access to each staff member for applicable provider IDs.
Q: On the Beneficiary Eligibility window, where are the HCBS programs listed?
In the Eligibility section, which appears after the KBH and LTC information on the Beneficiary Eligibility window.
Q: To search by warrant date on the Claim Inquiry window, do both dates need to be filled out?
Yes. This feature searches the Paid Dates using the From Date and Thru Date search fields.
Q: When filing claims on the website, can the entry person be tracked?
Q: When we do a screen print from the website, will the date and time automatically be recorded on the printout?
Yes, the date and time are located on the top, left side under the banner and drop-down menus.
Q: When will remittance advices be available to view on the website?
Remittance advices (RAs) are available after the first financial cycle. The RA files posted to the website are data files in the format of a HIPAA 835 transaction layout. The data is available for download but since it is in the 835 format it is not easily readable to most users.
Q: How are the KAN Be Healthy (KBH) windows updated?
The KBH windows are updated when an electronic or paper CMS 1500 Claim Form is submitted and satisfies all of the following conditions:
The KBH beneficiary is actively enrolled in a Title XIX/XXI program. The KBH beneficiary identification number and name match. A KBH-specific CPT code is used. For more information, reference the KAN Be Healthy - Early and Periodic Screening, Diagnostic, and Treatment Provider Manual on the Provider Manuals page.
Q: In the future, will we be required to purchase an audiometer to complete a KBH hearing screen?
No, purchasing audiometry equipment is not required. KMAP providers have the option of using the age-appropriate paper hearing screening form(s). These forms are available on the Forms page. Refer to the KAN Be Healthy - Early and Periodic Screening, Diagnostic, and Treatment Provider Manual on the Provider Manuals page for further instructions.
Q: Is a referral from the beneficiary's primary care physician needed if the KBH screen is completed at a local health department?
Yes. A referral from the beneficiary's primary care physician is needed. Q: Since there are procedure codes that update all four KBH screens, can beneficiaries still go to the dentist or eye doctor?
Yes. Beneficiaries can visit the dentist and eye doctor, with or without a current medical screen. Beneficiaries are encouraged to have a minimum of one check-up annually with a dentist (allowed two periodic visits per year) and are encouraged to have a vision screen annually. Some procedure codes update all four screens to help decrease the barriers for care.
Q: What are the documentation requirements when requesting reimbursement for a KBH screen using modifier EP?
Refer to the KAN Be Healthy - Early and Periodic Screening, Diagnostic, and Treatment Provider Manual on the Provider Manuals page for documentation requirements when billing with modifier EP.
Q: What are the four KBH screens?
The four screening types are: medical, vision, hearing, and dental. Refer to the KAN Be Healthy - Early and Periodic Screening, Diagnostic, and Treatment Provider Manual on the Provider Manuals page for additional information.
Q: What should we do if all of the recommendations have been met, but the KBH medical screen has still not been updated?
The following issues may have occurred when the KBH medical screen remains overdue or has not been updated:
The claim was not submitted in the correct format (electronic, CMS 1500 Claim Form, or ADA, depending upon procedure type). The beneficiary identification number and name did not match on the claim. The screen was not completed and submitted by an enrolled KMAP provider. A KBH-recognized procedure code was not used correctly. The claim has not adjudicated (paid or denied). Report any unresolved issues as soon as possible to the fiscal agent by contacting a Customer Service representative.
Q: Which CPT codes can be used to bill a KBH screen?
Refer to the KAN Be Healthy - Early and Periodic Screening, Diagnostic, and Treatment Provider Manual on the Provider Manuals page for an all-inclusive list of CPT procedure codes that will update the KBH screening date.
Q: Which vision CPT code should be billed when a KMAP provider, who is not an optometrist or ophthalmologist, completes a near distance acuity vision screen?
Use CPT code 99173 for distance acuity vision screen reimbursement for KBH beneficiaries.
Q: Can the MCO pay me less than what was paid in the fee-for-service program?
The MCO must pay you at least the fee-for-service rate that was in effect November 9, 2012, for services provided in-network. KDHE will provide a process for you to follow if you have specific examples of claims being paid at a lower rate than the traditional fee-for-service rate.
Q: If I need to file a grievance or appeal, what are my options?
Each MCO is required to provide a grievance and appeal process for their members and providers that meets federal regulations. As a provider, you will need to file a grievance or appeal with the MCO. You should review the provider contracts and/or manuals of that specific MCO for more information on the process. KDHE will also provide a grievance and appeal process that will allow members and providers to refer issues to KDHE in dispute of the MCO's adjudication of a grievance or appeal.
Q: Questions were asked during the KanCare meetings. Are there answers to those questions?
Answers to questions from the KanCare Educational Tours are now posted on the KanCare website by category.
Q: What if the MCO doesn't pay my claim quickly?
The contract signed by the MCO requires payment of ""clean claims"" within 30 days. KDHE will provide a process for you to follow if your clean claims are not being paid in a timely manner.
Q: What type of medical or insurance card will beneficiaries be presenting to the provider?
Beneficiaries assigned to a KanCare health plan will present with their MCO-issued card rather than a plastic State of Kansas Medical Card. There will continue to be some beneficiaries that are not assigned to a KanCare health plan for one or more months, and in these situations they may be provided with a plastic State of Kansas Medical Card that can be used to verify eligibility for billing KMAP.
Q: What will be the best way for a provider to verify eligibility after January 1, 2013?
Providers previously enrolled with KMAP can continue to use existing electronic methods to verify eligibility such as the KMAP secure website, AVRS, third-party software companies, or submission of a batch eligibility file. Eligibility verification responses will give providers details regarding the beneficiary's MCO based on the date of service used in the eligibility verification request.
Q: Will I submit my claims to the KanCare health plans or continue to file claims as I currently do?
KDHE will provide a process for claims submission at the appropriate time.
Q: Will each MCO have its own preferred drug list (PDL)?
No. The State will maintain the PDL.
Q: Do I have to sign a contract with all three new managed care organizations (MCOs)?
No, it is your choice. However, if you provide services for a consumer and you are not enrolled with that consumer's MCO, the service will be considered out-of-network. You will be paid by the consumer's MCO at 90% of their reimbursement rate to their in-network providers.
Q: If I choose not to enroll with any of the new MCOs, am I responsible for assisting current patients in finding a new participating provider?
No. The beneficiary will be responsible for finding a medical provider who participates with his or her assigned KanCare MCO plan. Additionally, the beneficiary will need to obtain his or her records or request that they be sent to the new medical provider. To ensure continuity of care, you can assist with this transition, especially if there is a critical medical condition currently being treated.
Q: If I choose not to enroll with any of the new MCOs, can I continue to treat Kansas Medicaid beneficiaries?
To be considered an in-network provider, you will only be able to see patients who are assigned to the MCO(s) you contract with. If you choose not to enroll with a certain MCO, you will be considered an out-of-network provider for the patients under that MCO. Out-of-network providers are paid 90% of the MCO's reimbursement rate for in-network providers.
Q: If I choose to enroll with all three MCOs, will I need to fill out a separate provider application for each one?
Yes. You will need to submit a separate application for each MCO. The MCO websites and KanCare website have the standardized application for hospitals, long-term care providers, and waiver services. For clinicians, complete the national standardized application on the CAQH website. Simply complete the applicable application and make copies to submit an application to each of the MCOs with whom you wish to enroll. Each MCO will need an original signature page to accompany application copies.
Q: What if I do not sign a contract with one of the new MCOs?
To be considered an in-network provider, you will only be able to see patients who are assigned to the MCO(s) you contract with. If you choose not to enroll with a certain MCO, you will be considered an out-of-network provider for the patients under that MCO. Out-of-network providers are paid 90% of the MCO's reimbursement rate for in-network providers.
Q: Who are the MCOs and how can I contact them?
Click on the name of the organization to access their website or contact them by phone or email. Aetna Better Health of Kansas 1-855-221-5656 (TTY: 711) Sunflower State Health Plan 1-877-644-4623 Email: SunflowerStateHealth@centene.com UnitedHealthcare Community Plan of Kansas 1-877-542-9238 For any questions regarding Amerigroup, contact: Amerigroup Kansas, Inc. 1-800-454-3730 Email: firstname.lastname@example.org
Q: Will any beneficiaries continue to be covered under the fee-for-service program?
Yes. There continues to be a fee-for-service population. Below are some groups that remain in the fee-for-service program:
MediKan SOBRA Tuberculosis (TB) Qualified Medicare Beneficiary (QMB) only AIDS Drug Assistance Program (ADAP) only Incarcerated members (INMAT) Presumptive Eligibility for Pregnant Women (PEPW) Some state hospital residents in specific categories PACE Medicaid-covered members who do not meet the KanCare MCO assignment criteria for particular months
Q: What is PES?
Provider Electronic Solutions (PES) is software provided by the fiscal agent for providers to use. This software allows you to batch and bill claims electronically.
Q: How can PES benefit me as a provider?
If you are billing the same services for the same beneficiaries month after month, you can just make some minor changes to your batches and resubmit all of those claims. For example, if you are a nursing home and billing for the room and board for the same beneficiaries, you would have submitted a batch for last month. After this month is over, you can access the last batch you sent, change the dates of service for the entire batch, and then resubmit them all again with the corrected information. For additional information on the benefits, contact the KMAP EDI team by email or by phone at 1-800-933-6593, option 4.
Q: How do I know what a field is used for in PES?
If you click inside the field and press F1, it will give you a description of the field and also indicate whether that field is required or optional.
Q: I want to backup my database. How do I do that?
Your database is a file named ksnewecs.mdb. Perform a search on your computer (Start-Search-Find Files or Folders) for this file and copy it to another location on your computer. If you are going to rely on this file for current information, remember to make frequent copies of the file. The PES User ID and Password used at the time the database is copied will be the same that you used if you choose to restore PES with a previous database file. If you still have problems performing this task, contact the EDI team at 1-800-933-6593, option 4.
Q: I've ruined or lost my PES database, but I have a backup. How do I restore my database?
Find your backup of the PES database and rename it to ksnewecs.mdb. Move this file into the folder your PES database resides in. The location of this file will default to C:\KShipaa if you chose a standard PES installation. Next, open your PES application and log in. Remember to use a User ID and Password that existed during the time you created the backup of the database. If you still have problems performing this task, contact the EDI team at 1-800-933-6593, option 4.
Q: I used to transmit just fine, but now PES tells me my transmission failed. What's wrong?
Check your communication log under Communication-View Communication Log. If the log says """"Invalid ID/Password,"""" chances are you have changed the password on your web account but haven't updated PES. To update PES, select Tools-Options-Batch and change the Web Password field to reflect what you currently use on the website. Then, try your transmission again.
Q: Can PES be installed multiple times?
No. Only one installation of PES will work on a single PC. However, you can load it to multiple PCs within the same office. PES supports billing for as many providers as necessary with a single installation.
Q: Can claims be """"tagged""""?
PES does not use the tag option. Instead, all claims in an """"R"""" status will be sent at one time.
Q: How many beneficiaries can be loaded into a list?
There is no limit on the number of beneficiaries that can be loaded.
Q: How many detail lines per claim type are allowed on PES?
PES limits the number of lines to 99 for Institutional and 50 for Professional.
Q: On PES Pharmacy claims, where does the TPL information need to be entered?
TPL information is entered on the Service 2 tab (Other Coverage).
Q: What operating system does PES require?
PES requires Windows 98/2000/XP. The system requirements are posted on the website.
Q: Will there ever be electronic attachments?
PES supports the HIPAA-compliant attachment control number. Providers should submit their claims with an attachment control number assigned by them. The attachment control number is then written on the attachment and mailed or faxed to KMAP where it will be paired up with the electronic claim.
Q: Can I view prior authorizations (PAs) and plans of care through the KMAP website?
Yes, you can view PAs and plans of care through the KMAP website. From the Main Menu, select Prior Authorization. When searching for a PA status, enter the information and click Search. When the results are returned, click on the PA number to display the PA Inquiry Results window. If you do not have the PA number, you need the beneficiary ID number and the assignment code. The NDC and Start Date fields are optional search fields for more specific data.
Q: What is the protocol for Preferred Drug List (PDL) PAs?
Pharmacies receive a PA determination at the time of billing a claim which either allows the claim to pay or directs them to contact the fiscal agent if additional information is needed. The fiscal agent processes PA requests received in accordance to established contract protocol.
Q: What portion of the form should the doctor fill out and what portion of the form should the pharmacy fill out?
In addition to processing requests at the point of sale, PA requests can be submitted by telephone or fax. Either the pharmacy or prescriber can request a PA; however, it is most often the prescriber who can answer the specific questions regarding the need for a particular drug. The most current PA forms are posted on the Kansas Department of Health and Environment , Division of Health Care Finance (KDHE-DHCF) website under the Medicaid and HealthWave/Pharmacy section. Use the form(s) posted on the website when submitting a PDL PA request. Do not make copies and use them without periodically checking the website for the newest form.
Q: Where do I send pharmacy PA requests?
If a beneficiary has coverage through KanCare, contact that group for prior authorization (PA). The fiscal agent processes PA requests for fee-for-service beneficiaries in the following circumstances: Medications administered in a physician's office Hospice medications not covered by the hospice provider Medication requests related to presumptive eligibility Medications billed by an out-of-state pharmacy Point of sale (POS) and other pharmacy-related PA requests received by telephone or fax - If related to a Traumatic Brain Injury rehabilitation facility - If a child must stay out-of-state following a transplant Noncovered KAN Be Healthy - Early and Periodic Screening, Diagnostic, and Treatment medications Providers who request PAs for these situations need to continue to contact the fiscal agent by telephone at 1-800-285-4978 or fax at 1-800-913-2229.
Q: Will there be a hard copy attachment option for PAs that require medical records, etc?
No, there is not a hard copy attachment option for PA requests. However there is a section where you can include comments on the PA request. Medical records, if necessary, will be requested at the time the PA request is reviewed.
Q: Can I use the same email address for multiple providers in the group?
The email address is to establish contact with the agent completing the application and can be used on multiple applications.
Q: Can you choose more than one Organization Type?
No, the Organization Type drop-down options include: For Profit Corporation and Not For Profit.
Q: Can you choose more than one Tax Classification?
No, the Tax Classification drop-down options include: FOR-PROFIT CLOSELY HELD and 501(C) 3 NON-PROFIT.
Q: Do you need to submit actual ink signatures or just the email validation?
The new Provider Enrollment Wizard was developed to accept an electronic signature. This removes the need for the wet signature.
Q: Does the provider application have to be done in a specific order?
In the Provider Enrollment Wizard, you must complete each section in order. However, after you save a section, you can go back to a previous section.
Q: For LEA providers, are we required to provide a SSN now for a Managing Employee?
Yes, the SSN is a requirement for all Managing Employees for all application types.
Q: For the effective date on the taxonomy code, what date should be used?
The date the NPI was issued is the appropriate effective date.
Q: How do we make the provider application fee payment?
Payment must be made in the form of a check or money order made out to the State of Kansas - Medicaid, and sent to Provider Enrollment at PO Box 3571, Topeka, KS 66601-3571. Note the Application Tracking Number (ATN) on the check.
Q: I am adding a member to an existing group but the name of the group isn't the group I wanted to add the member to?
To add a member to a group, you will need to contact the Provider Enrollment team at 1-800-933-6593, Option 3, to obtain the correct Group Number. The name will display only the Primary group name, but the number will associate the group member to the group you have confirmed with Provider Enrollment.
Q: If a provider changes their tax ID number, is this considered a new enrollment?
Yes, changing a tax ID number will require a new application.
Q: Is there a limit to the quantity or size of the documents in the Provider Enrollment Wizard?
There is a size limit of 4 MB. If you need to upload a document that is larger than 4 MB, you can submit the document by fax or mail. Fax it to 785-266-6112, or mail it to KMAP, PO Box 3571, Topeka, KS 66601-3571. Include the Application Tracking Number (ATN) with any documentation.
Q: On the Address Page, will the Same as Above fill in all of the name and address fields if the Pay To Name is different than the enrollment name?
The Same as Above option should only be used if the provider being enrolled should receive the payment for services rendered. This option brings over the enrollee's name and does not provide an option to change the Pay To Name. This could result in payments being made to the wrong name and address.
Q: On the Attachments Page of the enrollment application, I don't see a list of the required attachments needed to complete the enrollment for my specialties.
If you don't see a list of required attachments for your specialty, contact the Provider Enrollment team at 1-800-933-6593, Option 3.
Q: We don't have to enroll again until 2021. Will we be reminded of when to enroll?
Revalidation reminders will continue to be sent, and a training video is available on the Provider page of the KMAP website to review the system.
Q: What is the website for the new Provider Enrollment Wizard?
The new Provider Enrollment Wizard can be accessed using the links displayed on the KMAP Home, Provider, and Provider Enrollment Application pages. Select the option for a new application or revalidation.
Q: What license expiration date should be entered if my provider type and specialty aren't required to be licensed?
If you don't have a license or the license does not have an expiration date, enter 12/31/2299.
Q: What number do we call to get our ID numbers?
Contact the Provider Enrollment team at 1-800-933-6593, Option 3.
Q: When adding an individual to a group will you still be required to include the employer W-9 and liability insurance declaration page?
The W-9 and Insurance are required for all providers. A list of required documentation will display as you complete the Provider Enrollment Wizard.
Q: When reviewing my revalidation application, I got an error, ""Select at least one Waiver Type"", when attempting to proceed from the Specialty page when I had already selected waiver type, how do I continue?
Edit the specialty line by clicking on the pencil icon, then click Save. If necessary, contact the Provider Enrollment team at 1-800-933-6593, Option 3.
Q: When will the new Provider Enrollment system be available?
The new Provider Enrollment Wizard has been available since March 12, 2018.
Q: When will we start getting notifications for revalidations?
Revalidation notices will be sent 90 days prior to the due date. A second reminder is sent 60 days prior to the due date.
Q: Where do I find the User Guide for the Provider Enrollment Wizard?
The Provider Enrollment Wizard Guide is available on Inquisiq, the Learning Management System (LMS), where you may have enrolled for the instructor-led training. To access the LMS, go to https://lms-ks.myhcplatform.com/ and sign in or register. Click on Course Catalog and select the Provider Enrollment ILT or CBT course. You can then click on the upcoming Provider Enrollment CBT class to go to the detail page and view the guide. It is on the left under Course Materials.
Q: Where do we find the definition of a subcontractor?
The definition of subcontractor is available on the Disclosure of Ownership and Control Interest Statement located under the Provider Information heading on the Forms page of the KMAP website.
Q: Why can't the provider enrollment fee be paid electronically?
The State of Kansas does not offer that option.
Q: Will all groups be available for selection in the new system when we begin adding new providers to our group?
Yes, all actively enrolled groups are available in the system. As you add new members to your groups, you will need the group number for the group you want them to be a member of. Contact the Provider Enrollment team at 1-800-933-6593, Option 3.
Q: Will each new group application (for additional service locations) require the fee?
The fee will be required for any qualifying enrollment. Reference General Bulletin 17298 on the Bulletins page of the KMAP website for the most current information regarding the enrollment fee.
Q: Will the Provider Enrollment Wizard application work better with Google, Firefox, Explorer, or something else?
The new Provider Enrollment Wizard works well in all of these browsers, but we recommend Internet Explorer.
Q: Will there be an option to select all three plans?
This will be a future option.
Q: Are existing providers required to enroll again using the new Provider Enrollment system?
No. Although some states have required existing providers to re-enroll, Kansas does not. We have moved all existing provider information into the new system.
Q: I received a notification that my Provider Enrollment application is being returned to me for corrections. What do I need to do?
Access the Resume/Revalidate Enrollment page of the Provider Enrollment Wizard. This link is available on the Home, Provider, and Provider Enrollment Applications pages of the KMAP website. Enter the Tracking Number and Password. Make the appropriate updates in the application. Remember to Save and Continue as you navigate through the pages. Sign the Agreement and submit again. If you received this notice for a new enrollment, you have 60 days from the notice date to resubmit the application with corrections. After 60 days, the Tracking Number expires and you will no longer be able to resume. If you received this notice for a revalidation, you must submit the corrected application no less than 5 business days prior to your revalidation due date or risk termination.
Q: I submitted my Provider Enrollment application. Now what happens?
First, your application is sent to our screening service. The applicant and all named disclosed entities are checked against state and federal databases, as required under ACA. Next, your application and screening results are sent to our Provider Enrollment team for review. We confirm all of the required information and attachments for your provider type and specialty are included and review the screening results. The application may have to be returned to you for corrections or additional information. If you are a moderate-risk provider type, you are subject to an unscheduled site visit. If you are a high-risk provider type, you are subject to a site visit and criminal background check. The State will render its enrollment decision once all data has been reviewed.
Q: I was reviewing my new Provider Enrollment application and noticed some data is incorrect. The field is grayed out and I cannot edit it. What should I do?
When a field is grayed out in a new enrollment application, it is because it was copied from another area within the application. Return to the first place that you entered the information and change it there. Click Save and Continue, then navigate back to the page you were on. The data will be updated.
Q: If I submitted a new Provider Enrollment application in the old system and you return it to me for corrections, can I still access it or are you moving it to the new system?
Any returned applications that fail to comply with correction requests by the due date as notified will be deleted and a new application or revalidation will need to be started using the new Provider Enrollment Wizard.
Q: What happens to the Provider Enrollment application(s) I entered into the current system when the switch over to the new one is made? I haven't received my welcome letter yet.
Any application submitted prior to February 8, 2018, that has been reviewed and returned for corrections will need to be submitted in accordance with the communication sent to the contact on the application. Any returned applications that fail to comply with correction requests by the due date as notified will be deleted and a new application or revalidation will need to be started using the new Provider Enrollment Wizard. If you have not received your welcome letter, a written request to the Provider Enrollment team can be submitted by fax (785-266-6112) or email (LOC-KSXIX-Provider-Enrollment@groups.ext.hpe.com).
Q: Is the Kansas Organizational Provider Credentialing/Recredentialing Application also required for fee-for-service providers?
No. Providers need to enroll using the Provider Enrollment Wizard. The link for new applications is available on the Home, Provider, and Provider Enrollment Applications pages of the KMAP website.
Q: What is meant by ""wet signature""?
A wet signature is an original, ink signature that has not been photocopied.
Q: Where is the Kansas Organizational Provider Credentialing/Recredentialing Application located?
Both the Kansas Organizational Provider Credentialing/Recredentialing Application and HCBS Supplemental Form are available on the MCOs' websites, just as the current application is now. These documents are also on the KanCare and Forms pages of the KMAP website.
Q: Who can I contact with further questions regarding the Kansas Organizational Provider Credentialing/Recredentialing Application?
Please direct additional questions to any of the three MCOs.
Q: Will the Kansas Organizational Provider Credentialing/Recredentialing Application be required for provider revalidations too?
Yes. Providers must revalidate every three years with the MCOs.
Q: Can I bill for services during the time the provider number is inactive?
If you are inactivated, you will have the opportunity to back date your application or revalidation to maintain continuity of enrollment. Once approved, you will be eligible to submit claims for the time period when you were inactive. While your enrollment status is inactive, you will not be able to bill KMAP, use AuthentiCare, or verify eligibility for Medicaid-enrolled members.
Q: How do I determine when my revalidation is due?
Call 1-800-933-6593 and select option 3 to speak to a Provider Enrollment specialist. Make sure to have your Kansas Medical Assistance Program (KMAP) identification (ID) number, National Provider Identifier (NPI), or Tax ID number available when you call. This will allow the representative to answer your questions accurately.
Q: How do I reset my KMAP password?
Call Customer Service at 1-800-933-6593 and select option 6 to speak with a Customer Service representative who can assist you.
Q: How do I start my revalidation?
Access the Resume/Revalidate Enrollment page of the Provider Enrollment Wizard. The link is on the Home, Provider, and Provider Enrollment Application pages of the KMAP website.
Q: I have more than one location. Do I revalidate all of my locations at the same time?
Not necessarily. Be sure to pay attention to which location you are revalidating.
Q: I was inactivated. How do I become active again?
If you were inactivated for No Revalidation, you have 30 days from the revalidation due date to access the Resume/Revalidation page of the Provider Enrollment Wizard and complete your revalidation. If you were inactivated after 30 days from the due date, you will need to start a new application with the Provider Enrollment Wizard. Both links are available on the Home, Provider, and Provider Enrollment Applications pages of the KMAP website.
Q: What is the status of my application or revalidation?
Access the Provider Enrollment Wizard for new applications. Click the yellow Menu box at the top of the web page. Under Provider Enrollment, click the Enrollment Status link.
Q: Will I be termed for not revalidating?
Yes. You will be inactivated on the date stated on the letter sent prior to your revalidation due date. Once the revalidation is complete, as long as all enrollment requirements are met, you will be reinstated with no lapse in enrollment.
Q: Can local police stations do fingerprints?
Yes, any law enforcement agency authorized to take prints is acceptable.
Q: Do individuals who reside outside of Kansas need to come to Kansas to have fingerprints taken?
No, any law enforcement agency authorized to take prints is acceptable. The law enforcement agency taking the prints is responsible for mailing them to KDHE/DHCF in the addressed stamped envelope you provide.
Q: Do the FCBC requirements that apply to state Medicaid programs also apply to CHIP programs?
Yes. Under 42 CFR 457.990(a), the Medicaid provider screening and enrollment rules at Part 455, subpart E, including the FCBC requirements discussed in these FAQs, apply to the state's CHIP just as they apply to the state's Medicaid program.
Q: How long does it take to complete the criminal background check once the fingerprints are received?
The criminal background check will take 5-10 business days.
Q: In the case of a ""high"" risk provider enrolled in Medicare, is the state Medicaid agency required to conduct an FCBC if the provider wants to enroll (or re-enroll) in Medicaid or seeks to revalidate its current enrollment?
Not if the state Medicaid agency is able to rely on Medicare's screening by confirming the provider or organization is a positive match. The state Medicaid agency will compare minimum required data elements through PECOS to verify a match between Medicaid and Medicare. Under 42 CFR 455.410(c), state agencies may rely on a provider's Medicare enrollment even if Medicare has not conducted an FCBC with respect to that provider.
Q: Is this mandatory per statutory requirement by regulation?
Yes. CMS implemented provider screening requirements for Medicaid enrollment with federal regulations at 42 CFR Part 455 subpart E and at 42 CFR 457.990, which makes Part 455 subpart E applicable to CHIP. CMS published these regulations as a final rule in the Federal Register, Vol. 76, February 2, 2011, and were effective March 25, 2011.
Q: What if a provider or an owner of 5% or more doesn't submit fingerprints when requested to do so by a state Medicaid agency?
Under 42 CFR 455.416, a state Medicaid agency must terminate or deny enrollment of a provider if the provider, or any person with a 5% or greater direct or indirect ownership interest, who is required to submit fingerprints: - Fails to submit them within 30 days of the Medicaid agency's request; or - Fails to submit them in the form and manner requested by the Medicaid agency. In both cases, the agency may allow the provider to enroll if the agency determines that termination or denial of enrollment is not in the best interests of the Medicaid program and documents that determination in writing.
Q: What if the law enforcement agency will not mail the fingerprints to KDHE/DHCF?
Locate another law enforcement agency to take your prints.
Q: What if the results of a FCBC indicate that a provider or 5% owner has a criminal record?
Under 42 CFR 455.416, a state Medicaid agency must terminate or deny enrollment of a provider if the provider, or any person with a 5% or greater direct or indirect ownership interest, who is required to submit fingerprints has been convicted of a criminal offense related to that person's involvement with the Medicare, Medicaid, or CHIP program in the last 10 years. The types of convictions that warrant denial of enrollment are at the discretion of the agency. The agency may allow the provider to enroll if the agency determines that termination or denial of enrollment is not in the best interests of the Medicaid program and documents that determination in writing that is available to CMS or OIG upon request.
Q: What provider categories are ""high"" risk?
DME or Home Health Agency providers enrolled after March 2011 are designated a ""high"" category of risk. In addition, the state Medicaid agency must adjust the category of risk level to ""high"" when the following occurs: imposition of a payment suspension due to credible allegation of fraud; the provider has an existing Medicaid overpayment; or the provider has been excluded by the OIG or another Medicaid program in the previous 10 years.
Q: When a state Medicaid agency designates a provider or provider category as ""high"" risk, what is the state Medicaid agency required to do?
Under 42 CFR 455.450(c), when a state Medicaid agency designates a provider as a ""high"" categorical risk, the agency must: - Perform the ""limited"" and ""moderate"" screening requirements specified at 42 CFR 455.450(a) and - Require the submission of a set of fingerprints in accordance with 42 CFR 455.434 and - Conduct a criminal background check.
Q: When are individuals required to submit fingerprints to have a FCBC conducted?
Any person with 5% or more direct or indirect ownership interest in the provider designated with a ""high"" category of risk must submit fingerprints and undergo a criminal background check at initial enrollment, re-enrollment, and revalidation of enrollment.
Q: Who is required to submit fingerprints?
If a state Medicaid agency designates a provider as a ""high"" risk, the provider and any person with 5% or more direct or indirect ownership interest in the provider must submit fingerprints and undergo a criminal background check, per 42 CFR 455.434(b). 42 CFR 455.101 defines an ""ownership interest"" as the possession of equity in the capital, the stock, or the profits of the provider. An ""indirect ownership interest"" means an ownership interest in an entity that has an ownership interest in the provider.
Q: Who is responsible for the cost of conducting FCBCs for ""high"" risk providers?
The ""high"" risk provider is responsible to pay the costs associated with obtaining fingerprints. Under 42 CFR 455.460(a), state Medicaid agencies must collect application fees prior to executing a provider agreement and this application fee is intended to cover the costs associated with a state's Medicaid provider screening program, including the costs of conducting an FCBC on ""high"" risk providers.
Q: Who mails the fingerprint card to KDHE/DHCF?
The law enforcement agency who takes the prints is responsible for mailing them to KDHE/DHCF in the addressed stamped envelope you provide.
Q: Why does a state Medicaid agency have to conduct FCBCs?
The federal regulation at 42 CFR 455.410(a) provides that a state Medicaid agency must require all enrolled providers to be screened according to the provisions of Part 455 subpart E. These provisions require the agency to screen all provider applications for enrollment, including initial applications, applications for a new practice location, and applications for re-enrollment or revalidation, based on a categorical risk level of ""limited"", ""moderate"", or ""high"" (42 CFR 455.450). The agency must establish categorical risk levels for providers and provider categories who pose an increased financial risk of fraud, waste, or abuse to the Medicaid program. When the agency determines that a provider's categorical risk level is ""high"", or when the agency is otherwise required to do so under state law, the agency must require providers to consent to criminal background checks, including fingerprinting (42 CFR 455.434).
Q: How do I update my NPI with KMAP?
To make a change to your NPI, the NPPES verification and written request on letterhead can be faxed to the Provider Enrollment team at 785-266-6112 or mailed to KMAP, Attn: Provider Enrollment, PO Box 3571, Topeka, KS 66601. If it is a correction to what is already on file, indicate that on the form. A note such as ""Correction to NPI information"" alerts the Provider Enrollment team to the change, rather than potentially causing them to think it is a duplicate update. If you have any questions, contact Provider Enrollment at 1-800-933-6593.
Q: Can I find provider enrollment forms on the KMAP website?
Yes. Provider Enrollment forms are available on the Provider Enrollment Applications page of the KMAP website. Beneath each application is a generalized list of which types of providers would fill out that specific application. For additional questions, you can contact the Provider Enrollment team at 1-800-933-6593.
Q: How do I change my address and/or phone number?
If you need to update your address or phone number with the fiscal agent or KMAP, fill out the Provider Update form under Provider Information on the Forms page and either mail or fax it to the Provider Enrollment team. This form can be faxed to 785-266-6112 or mailed to KMAP, Attn: Provider Enrollment, PO Box 3571, Topeka KS 66601. If you have any questions, contact Provider Enrollment at 1-800-933-6593.
Q: Which application should I fill out to enroll as a KMAP provider?
Access the Provider Enrollment Wizard for new applications. The link is on the Home, Provider, and Provider Enrollment Application pages of the KMAP website. For additional questions, contact KMAP at 1-800-933-6593.
Q: What dates of service or processing dates are affected by the new 835 project?
New claims submitted after January 1, 2011, regardless of the date of service, require the use of the HIPAA-compliant codes. Adjustments submitted to claims with dates of service after January 1, 2011, require the use of the HIPAA-compliant codes; claims with dates of service prior to January 1, 2011, are unaffected.
Q: When do I enter payment information at the header level instead of the detail level?
Claim adjustment reason code (CARC) information should only be submitted in the CARC portion of the TPL/Medicare section if it applies to the entire claim. This is considered the header level. There are only two situations where payment information is added here on professional claims: if there is only one line item or if the primary insurance only pays at the header level and there is no detail information available. For institutional inpatient claims, enter this information at the header level in the TPL/Medicare section. If CARC information is added here, you cannot add it a second time in the detail section under Payer Information. The claim will not balance and will not process.
Q: I am getting a balancing error. What information do I need to verify in order to submit?
Each sum of the line detail payments must balance to the header paid amount; meaning, everything has to balance. If your billed amount is $100.00 and TPL/Medicare paid $25.00, you need to have $75.00 worth of CARC information added at the detail level. All detail lines for CARC information plus the TPL/Medicare paid amount equals the total billed amount. In addition, CARC information cannot be submitted at both the header and detail level. The header level is defined as the TPL/Medicare section, and the detail level is defined as the Payer Information section. Each line item must balance individually. If your claim is not balancing: Verify the CARC information is not entered at both the detail and header level. The CARC information can only be entered once per payer. Verify the full Paid Amount is in the header TPL/Medicare section. Verify the contractual obligation (CO) or write-off amount information is in the CARC section.
Q: How do I enter multiple TPL information?
Both third-party liability (TPL) payments have to balance to the billed amount. If a payment is made by two or more payers before billing KMAP, the secondary payer information must still balance to the billed amount. If Payer 1 pays $100.00 toward a $200.00 billed amount, Payer 2 needs to include an explanation for the difference between the payment amount and the billed amount balance. Payer 2 must proceed as if a primary payment was not made when explaining exactly what equals the billed amount. If an explanation is not provided on the explanation of benefits (EOB) from the primary insurance, indicate an adjustment for the primary payer's payment with an other adjustment (OA) code. Example: The billed amount equals $200.00. Payer 1 made a $100.00 payment that is entered in the Paid Amount field of the TPL/Medicare section. In the Payer Information section, enter CARC information for PR 1 Deductible as $25.00, PR 2 Coinsurance as $25.00, and CO 45 Contractual Obligation as $50.00. Payer 2 made a $50.00 payment that is entered in the Payer 2 Paid Amount field of the TPL/Medicare section. Payer 2 has to balance to the full billed amount. To count toward the $200.00 billed amount, enter CARC information for OA 94 Other Adjustment as $100.00 and CO 45 Contractual Obligation as $50.00.
Q: How can I enter negative amounts?
If another insurance or Medicare pays more than the billed amount, the CARC information is entered as a negative amount to balance the billed amount and the total paid amount including adjustments by the other insurance or Medicare. This usually occurs with claims billed by rural health clinics, federally qualified health centers, and Indian Health Services; however, this applies anytime the primary insurance pays more than the billed amount. Example: The billed amount equals $200.00. Payer 1 made a $300.00 payment that is entered in the Paid Amount field of the TPL/Medicare section. In the Payer Information section, enter CARC information for PR 1 Deductible as $25.00, PR 2 Coinsurance as $25.00, and OA 94 Other Adjustment as $-150.00.
Q: When do I enter CARC 192?
CARC 192 indicates CARC information is not provided by the primary insurance. This is used anytime you receive a non-HIPAA compliant EOB from the primary insurance.
Q: What information needs to be included to process a paper claim?
If a beneficiary has other applicable insurance and you are submitting a paper claim, you must attach a copy of the EOB and/or remittance advice (RA) from the other insurance company for all affected services. An adjustment group code must always be used in conjunction with a CARC to show the liability for amounts not covered or to identify a correction or reversal of a prior decision. Acceptable group codes include: contractual obligation (CO), patient responsibility (PR), correction and reversal (CR), other adjustment (OA), or payer-initiated reductions (PI). If the other insurance does not specify this information, then you must write it on the EOB or RA. If the EOB from the other insurance does not include all proportioning of the monies, the claim will be returned to the provider (RTP). The EOB must clearly indicate the paid amount, patient responsibility, and contractual write-off. If the EOB does not specifically indicate these things, you must write on the face of the EOB. Example: Paid Amount equals $100.00; PR 1 Deductible equals $25.00, and CO 45 Provider Write-off equals $75.00.
Q: What are the definitions for the group codes?
CO - Contractual Obligation. This group code is used when a contractual agreement between the payer and payee, or a regulatory requirement, resulted in an adjustment. Generally, these adjustments are considered a write-off for the provider and are not billed to the patient. CR - Correction and Reversal. This group code is used for correcting a prior claim. It applies when there is a change to a previously adjudicated claim. When correcting a prior claim, CLP02 (claim status code) needs to be 22. See ASC X12N Health Care Claim Payment/Advice Implementation Guide (835) section 2.2.8 for complete information about corrections and reversals. OA - Other Adjustment. This group code is used when no other group code applies to the adjustment. PR - Patient Responsibility. This group code is used when the adjustment represents an amount that should be billed to the patient or insured. This group code is typically used for deductible and copayment adjustments. PI - Payer Initiated Reduction. This code is used when, in the opinion of the payer, the adjustment is not the responsibility of the patient, but there is no supporting contract between the provider and the payer (such as medical review or professional review organization adjustments). If the group code is not provided by the primary payer, use your best judgment to identify which group code matches the CARC used.
Q: Do I need Form 1095-B to file my taxes?
For the 2018 tax reporting year, Form 1095-B does not have to be submitted to the IRS at the same time you file your taxes. You should keep this form because the IRS or your tax preparer may ask you for a copy as proof of coverage. You do not need to attach Form 1095-B to your tax returns.
Q: How can I get my Form 1095-B mailed to my new address if I recently moved?
To have your reprinted Form 1095-B mailed to a different address, call 1-866-305-5147. Make sure you have your Medicaid ID number with you when you make the call.
Q: If information on my Form 1095-B is wrong, can I get a corrected form?
Yes. If the name, Social Security number (SSN), or date of birth (DOB) is wrong on the form, you need to call the KanCare Clearinghouse at 1-800-792-4884 to have your information updated. Changes made by the KanCare Clearinghouse for SSN and DOB will automatically create a corrected form. If you need a corrected form for only a name change, call 1-866-305-5147.
Q: Is Form 1095-B available in languages other than English?
Currently, Form 1095-B is only available in English. For help in another language, see your tax preparer or go to one of the IRS websites at www.IRS.gov/freefile or www.IRS.gov.
Q: Is this the only year I will get Form 1095-B?
You will get a form each year you have qualifying healthcare coverage. If you continue to have qualifying healthcare coverage through Medicaid/KanCare, you will continue to get this form from Medicaid/KanCare. Form 1095-B is a requirement of ACA. Each year you will need to be able to show that you have minimum essential coverage to avoid an IRS penalty.
Q: What if I do not receive or lose my Form 1095-B?
If you have not received your form by February 15, 2019, or you get your form and lose it, call 1-866-305-5147. A new form can be created and mailed to you. Make sure you have your Medicaid identification (ID) number with you when you make the call. The deadline has been extended to March 04, 2019.
Q: What if I was only insured for part of the year? Will I still get Form 1095-B?
Yes. If you had qualifying healthcare coverage for even one day during the previous calendar year, you will get Form 1095-B. The form will report which months you had coverage or if you had coverage for the whole year.
Q: What is Form 1095-B?
For the 2018 tax year, certain Kansas Medicaid/KanCare consumers will get an Internal Revenue Service (IRS) tax form from the Kansas Medicaid/KanCare program. It is called Form 1095-B. The form shows the months of the year that the person listed on the form was enrolled in medical coverage. Form 1095-B reports only coverage that meets the IRS definition of """"minimum essential coverage"""" so not everyone will get a form. It is required under the Affordable Care Act (ACA).
Q: What is a tax penalty?
You may have to pay a tax penalty if you do not have qualifying health care insurance (referred to as minimum essential coverage), and you do not apply for and get an exemption from the IRS. Refer to www.IRS.gov/ACA for more details on the individual mandate for health insurance and rules that apply to gaps in coverage, including information about getting an exemption from the penalty.
Q: When will I receive Form 1095-B?
Forms for the 2018 tax year must be mailed no later than January 31, 2019. The deadline has been extended to March 04, 2019.
Q: Where will my Form 1095-B be mailed?
The form will be mailed to the last address on file with Medicaid/KanCare on the day the form is created.
Q: Who will get Form 1095-B?
Any person who received minimum essential coverage through the Medicaid/KanCare program during the previous calendar year will get Form 1095-B. Most Medicaid/KanCare coverage meets the minimum essential coverage criteria. People with more limited programs like those listed below will NOT get Form 1095-B. The groups that will NOT get Form 1095-B are: Medically Needy with unmet spenddown, Qualified Medicare Beneficiary (QMB), Low-Income Medicare Beneficiary (LMB), Expanded Medicare Beneficiary (ELMB), Presumptive Pregnant Woman, SOBRA, Inmate, AIDS Drug Assistance Program-Full Benefits (ADAPD), and Tuberculosis (TB).
Q: Why does Form 1095-B matter to me?
Form 1095-B is an informational form that lets you know which months during the previous calendar year you had qualifying healthcare coverage. For tax purposes, you need proof that you had the minimum essential coverage to not pay extra money in taxes.
Q: Will my child receive Form 1095-B?
Yes. If your child had qualifying healthcare coverage through Medicaid/KanCare, a form will be created for him or her. An individual Form 1095-B will be created for each qualifying person.
Q: What is the process if the provider disagrees with a denial related to NCCI/MUE?
At this time, KDHE-DHCF is still researching the appeals process for NCCI/MUE issues. Most likely, the provider will need to follow the current process for a fair hearing. Refer to Section 5300 in the General Billing Fee-for-Service Provider Manual for more information.
Q: Will KMAP allow overrides of NCCI using the modifiers, similar to Medicare?
KMAP recognizes all the modifiers identified in the NCCI documentation provided by CMS. However, in some cases state policy indicates that payment will not be made. In these situations, the outcome of the claims will not be the same as when processed by Medicare. For example, if IV services are provided on the same day as an ER visit, state policy clearly indicates that those services are included as part of the ER visit and no additional payment will be made even with a modifier.
Q: Are the Medicaid NCCI/MUE guidelines the same as the guidelines currently used for Medicare?
KDHE has reviewed the files, and it appears there are several codes Medicare edits for that Medicaid won't edit. For more details, see the CMS website.
Q: Are we supposed to bill KMAP like we bill Medicare when they exceed the MUE limitation? Example: For Medicare we bill the allowed MUE edits on one line, then bill any units that exceed the MUE limitation on a second line with a modifier.
Bill KMAP in the same manner you bill Medicare. If the number of units billed on one line exceeds the MUE limitation, the entire line item will deny. The second line with the modifier will most likely deny as duplicate.
Q: Line items denied for NCCI/MUE will have a specific notation on the EOB. If the line item denies and the EOB does not specifically indicate it was part of NCCI/MUE, then it is safe to assume it was denied due to a state policy in place.
Line items denied for NCCI/MUE will have a specific notation on the EOB. If the line item denies and the EOB does not specifically indicate it was part of NCCI/MUE, then it is safe to assume it was denied due to a state policy in place.
Q: Will KMAP allow overrides of the MUE unit limitations with modifiers since Medicare allows this?
If the provider bills more than the maximum units allowed per MUE, the entire line item will deny. Reference the CMS website for additional information.
Q: Will KMAP allow payment for units over the MUE limitation with the use of a modifier similar to Medicare?
At this time, KMAP will not allow payment for units above the MUE limitation, even with modifiers. KMAP is in the process of reviewing the policy and edits to see if there are situations where this could be allowed.
Q: Will KMAP be using both the OPPS and Practioner guidelines?
Yes, KMAP will use both sets of guidelines. KMAP will be using provider type and specialty to determine which set is applied to the claim submitted.
Q: I have lost my medical card, how do I get a new one?
If you are assigned to a KanCare plan contact, - Aetna Better Health of Kansas, 1-855-221-5656, https://www.aetnabetterhealth.com/Kansas - Sunflower State Health, 1-888-644-4623, http://www.sunflowerhealthplan.com/ - UnitedHealthcare, 1-877-542-9238, http://www.uhccommunityplan.com/ If you are not assigned to a KanCare plan, call KMAP Customer Service at 1-800-766-9012.
Q: We just got approved for coverage, but I didn't receive a medical card for all of my family members. Why?
If any of the family members had coverage in the last 12 months, a new card is not sent. If you didn't save the card, you may request a new one. See above for instructions on requesting a new card. Up to four medical cards will be mailed in one envelope. If you have more than four family members with coverage, you should expect another envelope with the other cards. If you don't receive another envelope within a few days, contact KMAP at 1-800-766-9012. If you have less than four family members with coverage, and no one had coverage in the last year, contact KMAP for more information at 1-800-766-9012.
Q: What is Other Health Insurance?
Other insurance refers to medical coverage a member may have in addition to their medical card benefits. Other health insurance coverage may be provided by:
- Your job
- Your spouse's job
- A court-order for medical support
- Other sources
Q: What is TPL?
TPL (third-party liability) means you have other insurance that must be billed before Medicaid/KanCare will consider coverage. You must follow the rules of your other insurance. If you have other insurance or to report changes to your other insurance, call KMAP Customer Service at 1-800-766-9012.
Q: Why is Other Health Insurance important?
When a member has other health insurance this must be used before Medicaid is billed.
Q: What should I do if I have Other Health Insurance?
All members need to report other health insurance coverage they have for themselves or anyone who is on their case. When a member has an appointment with a medical provider, they must present their medical card as well as their other health insurance card. Members with other health insurance must also follow the rules of their health plan, such as using medical providers that have been approved by the plan.
Q: How do I report Other Health Insurance?
Reporting other health insurance can be done on this site by clicking on the Other Health Insurance link found on the My Home page from the Member Web Services site. For assistance, please use the Help links that can be found on this site. These Help links are marked with a question mark (?) and can be clicked to get information about the window you are viewing.
Q: I have been told that I don't have coverage right now. Why not?
To find out why you don't have coverage, you should talk to an eligibility expert about your specific case by contacting the KanCare Clearinghouse (toll free 1-800-792-4884).
Q: I may need help with medical bills. Do I qualify for any coverage?
Eligibility information is available through the KanCare Clearinghouse. Or, click here for more information.
Q: Who do I call with questions about eligibility?
Contact the KanCare Clearinghouse at 1-800-792-4884.
Call: 1-800-792-4884, between 8:00 am and 5:00 pm M-F
Write: PO Box 3599 Topeka, Kansas 66601
Q: Am I currently covered by a medical program?
You can check to see if you are currently eligible through these methods: From your 'My Home' page of Member Web Services, click 'Check my Eligibility' and then select the member from the 'Member List'. Use ROSIE, the automated attendant. Call 1-800-766-9012 and select Option #1. Contact KMAP Customer Service 1-800-766-9012.
Q: Is this service covered?
To verify if a service is covered, you must contact your doctor to obtain the procedure code and diagnosis code. If you are assigned to a KanCare plan, you need to call the number on your KanCare medical card. If you are not assigned to a KanCare plan, call KMAP Customer Service at 1-800-766-9012.
Q: Why do I not have coverage?
To find out why you don't have coverage, contact the KanCare Clearinghouse (toll free 1-800-792-4884).
Q: What type of coverage do I have?
From your 'My Home' page of Member Web Services, click 'Check my Eligibility' and then select the member from the 'Member List' to find the type of coverage you have. Click here for a description of the your coverage type.
Q: I have a KanCare plan assignment. What does that mean?
You will be assigned to a KanCare plan. Aetna, Sunflower, or UHC will be responsible for providing your KanCare benefits. When you are assigned to a KanCare plan, you will receive two packets in the mail. The first will be an enrollment packet explaining your assigned KanCare plan and your KanCare options. You have 90 days after approval to ask for a different plan. To change your plan, call the Enrollment Center at 1-866-305-5147. The second will be a welcome packet from your KanCare health plan. This packet will include your medical card. Your plan will assign you to a primary care provider (PCP). If you want to change your PCP, contact your KanCare plan.
Aetna Better Health of Kansas, 1-855-221-5656, https://www.aetnabetterhealth.com/Kansas
Sunflower State Health, 1-888-644-4623, http://www.sunflowerhealthplan.com/
UnitedHealthcare, 1-877-542-9238, https://www.uhccommunityplan.com/ks/medicaid/community-plan.html
Q: What is a Spenddown?
A spenddown is like an insurance deductible, where you must incur medical expenses before you qualify for full medical benefits. For more details about spenddown, click here.
Q: I am covered under Hospice. What does that mean?
Hospice services are provided for members who are terminally ill. These services must be ordered by a medical provider. The goals of Hospice services are to:
Ease and prevent a member's pain
Provide comfort for a member
Improve a member's overall quality of life
Q: I am on Lock-In. What does that mean?
A member is placed on Lock-In status when they have abused their medical card benefits. Medical card benefits can be abused by:
Allowing another individual to use your medical card
Going to the emergency room when there is no medical emergency
Using several medical providers to obtain the same kind of drug
Writing a fake prescription
Trading your Medicaid number for money or other things
You will be on Lock-In for at least two years. When you are on Lock-In, you can only go to one medical provider, one pharmacy, and one hospital. If you go to other providers while on Lock-In, you might have to pay the bill. The name of this provider is listed for you in your Member Web Services page. From your 'My Home' page, click on 'View Lock-In/Hospice Designation'.
Q: What does it mean to have a Living Arrangement/Level of Care?
These special codes show that you have been approved for long term care services. In order to qualify for long term care, you must have a medical need. Because specialized treatment is needed for some conditions and because services are offered in a variety of settings, it is important that your record show the type of care you are eligible to get. Only people with these special codes are eligible for payment of long term care expenses.
Q: What is a Living Arrangement and a Level of Care?
The Living Arrangement is the place or location where you receive personal services. This also specifies where you live.
The Level of Care is the type of personal services you have been approved to receive on a regular basis.
Q: What types of Long Term Care services are offered?
We offer many types of long term care services. From your 'My Home' page, click on 'View Living Arrangement/Level of Care Details' to find the type of care you are approved for. Click here for a description of each type of care.
Q: What is KAN Be Healthy?
KAN Be Healthy or KBH is a program that is designed to:
Prevent illness - with regular check-ups and immunization shots.
Find health problems early - by seeing a medical provider on a regular basis. Finding a health problem early makes it easier to treat.
Q: Who is eligible for the KAN Be Healthy program?
Children from birth to age 20 who receive Medicaid.
Q: What services are covered by KAN Be Healthy?
Some over-the-counter medicines (a prescription is needed; check with a pharmacist for more information)
Rides to a medical provider
Diet and nutrition appointments
Q: When should my child see a medical provider for KAN Be Healthy services/screenings?
At months 1, 2, 4, 6, 9, 12, 15, 18, and 24
At ages 3, 4, 5, 6, 8, 10, and 11-20
Any time your child is due for a Kan Be Healthy appointment
Q: When should my child see a dentist for KAN Be Healthy services/screenings?
Every year for cleanings, fluoride treatments, fillings, and pulling teeth.
Q: When should my child see a vision specialist for KAN Be Healthy services/screenings?
At age 3 Every 2 years after age 3
Q: When should my child see a hearing specialist for KAN Be Healthy services/screenings?
At least every 3 years.
Q: How do I know when my last screening was and when the next one is due?
From your 'My Home' page, click 'Kan Be Healthy' to view information about your last and next screenings.
Q: What if I cannot show up for my doctor's appointment?
Call your doctor as soon as you know you will not be able to make the appointment (at least 24 hours in advance, if possible).
Q: When should I go to the emergency room?
You should go to the emergency room only when you believe you have a true emergency. If you believe there is a true emergency, you do not need to call your doctor before you go to the emergency room. A true emergency is a problem that is life threatening or may cause you to lose your arm, leg, or any other part of your body.
Q: I think I am pregnant. What do I do?
Your medical card will pay for medically necessary pregnancy care. Schedule an appointment to begin prenatal care. Contact your eligibility worker at the KanCare Clearinghouse (toll free 1-800-792-4884). You should report the birth of your baby right after he or she is born.
As soon as you have your baby, call the KanCare Clearinghouse at 1-800-972-4884 to request coverage. A medical card can be issued in your baby's name. Call your managed care organization.
Q: Are vision services covered?
Coverage for vision services depends on the program you have. If you are assigned to a KanCare plan, you need to call the number on your KanCare medical card. If you are not assigned to a KanCare plan, call KMAP Customer Service at 1-800-766-9012.
Q: Can I receive payment for travel to medical services?
Nonemergent medical transportation (NEMT) services depend on your plan. If you are assigned to a KanCare plan, you need to call the number on your KanCare medical card. If you are not assigned to a KanCare plan, see the guidelines below or call KMAP Customer Service at 1-800-766-9012. Transportation can only be approved for services covered by Medicaid.
NEMT services are covered if no other ride is available only for the following people:
- Kan Be Healthy participants
- Pregnant women (for pregnancy-related services only)
- People going for renal dialysis, psychiatric medicine checks, or cancer therapy
- People receiving medical treatment more than 50 miles one way or 100 miles round-trip with documentation from your doctor stating medical necessity
To get transportation, you should:
- Get approval before the trip from KMAP Customer Service.
- Go to the nearest facility to receive the needed service/treatment.
- Keep track of mileage (for noncommerical provders).
- Log mileage ONLYwhen the member is in the vehicle.
- Return paperwork to the Medicaid program for payment.
- Contact a local commercial NEMT provider for transportation.
NOTE: The commercial NEMT provider must follow Medicaid's policies and rules as outlined in their provider manual.
Q: Are there times Medicaid will not pay for NEMT services?
Transportation services Medicaid will never pay for includes:
Adult and child day care, day camp, or school.
Trips to pick up anything (including medications, prosthetics, medical equipment, eye glasses, hearing aids, etc.)
Trips to attend nutrition, diabetes, or any other kind of educational or informational class.
Trips to water therapy or other noncovered therapies.
Trips to WIC clinics.
Trips to the chiropractor, acupuncture clinic, biofeedback, relaxation therapy, or hypnosis.
Trips for personal errands/shopping.
Trips for residents of nursing facilities or adult care homes.
Waiting time by the provider.
Local Education Agency (LEA) providers.
Attendants to assist drivers.
Trips for recreation or activity type trips.
If you are enrolled in managed care, your MCO may cover services that Medicaid does not. You should call your MCO to find when they will pay for transportation.
Q: What if I am not happy with services?
If you are assigned to a KanCare plan, you need to call the number on your KanCare medical card. If you are not assigned to a KanCare plan, call KMAP Customer Service at 1-800-766-9012.
Q: Can I use my smartphone or tablet to access the KMAP websites?
The KMAP websites can be accessed by most of the web browsers, For optimal performance use Google Chrome, Microsoft Edge or Mozilla Firefox.
For Tablets/Mobile devices, KMAP websites supports landscape mode only using Chrome (Android) and Safari (iOS).
Q: I forgot my KMAP password, can I still login?
No, contact KMAP Customer Service at 1-800-766-9012.
Q: I forgot my user ID, can I still login?
No, contact KMAP Customer Service at 1-800-766-9012.
Q: I'm having problems registering on Member Web Services, how do I register?
If you still have your registration letter, follow the steps on page 4. If you do not have the letter, contact KMAP Customer Service at 1-800-766-9012. They will assist you with the process.
Q: The website requires that I have an email account, but I don't have one. How do I get an email account?
If you do not have a personal email address, you can set one up as early as today. There are many different providers that offer free email services. You can search on the Internet for these providers by using the phrase free email service. Once you have chosen a provider, it only takes a few minutes to set up an email address. Click here to start your search for a free email address.
Q: What if I need help using the website or I don't understand the information on the screen? Are the below steps still correct for KMMS?
Help links can be found throughout the website. The Help links are located in the top right-hand corner of the screen and are marked with a question mark (?). Just click on the (?) to get more information about the window you are viewing. When you want to exit, close the help window by clicking on the (X) in the upper right-hand corner.
Q: I have trouble reading the small print, can you help me see the information better?
The website allows you to adjust the size of the text you are viewing. You can enlarge and reduce the text size by clicking on the '+' or '-' signs at the top of each screen.
Q: The information on the screen appears to be off center. Is there something wrong with my computer?
You probably need to adjust the resolution on your computer. An optimal resolution should be at least 1024 pixels wide. To adjust the resolution on your computer right-click on your computer's desktop. Choose properties. Click the 'Settings' tab and locate the 'Screen Resolution'. Change the screen resolution to a higher value.
Q: Who do I talk to if I want to apply for Medicaid?
Contact the KanCare Clearinghouse at 1-800-792-4884 between the hours of 8:00 am - 5:00 pm, Monday through Friday. You may also access their website at http://www.kancare.ks.gov/
Q: Who do I contact with questions about coverage?
If you are assigned to a KanCare plan, you need to call the number on your KanCare medical card. If you are not assigned to a KanCare plan, call KMAP Customer Service at 1-800-766-9012. You can also write:
KMAP Customer Service
PO Box 3571
Topeka, KS 66601
Q: Who do I call with questions about eligibility?
Contact the KanCare Clearinghouse at the information below:
Call: 1-800-792-4884, between 8:00 am and 5:00 pm M-F
Write: PO Box 3599 Topeka, Kansas 66601
Q: What doctors can I see?
If you are not assigned to a KanCare plan, you may search the Provider Directory.
If you are assigned to a KanCare plan, contact them.
1. Aetna Better Health of Kansas, 1-855-221-5656, https://www.aetnabetterhealth.com/Kansas
2. Sunflower State Health, 1-888-644-4623, http://www.sunflowerhealthplan.com/
3. UnitedHealthcare, 1-877-542-9238, http://www.uhccommunityplan.com/
Q: Where can I find more information about KanCare?
Click here to find out more information about KanCare.