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UnitedHealthcare Community Plan of Kansas Homepage

Help your patients avoid a lapse in their Medicaid coverage


Due to COVID-19, KanCare was not requiring members to renew their eligibility. Renewals are starting again this year and your patients might be required to renew.

We insure more pregnant moms, more children, and more aged, blind and persons with disabilities than anyone else. No one has a larger list of doctors and hospitals. We're a leader in working with community organizations to help the uninsured become insured, and the insured to get the best medical care possible. We're a leader in the effort to understand the social and cultural causes of disease. UnitedHealthcare has been in your community for years. We look forward to partnering with you.

We know you don't have time to spare, so we put all the UnitedHealthcare Community Plan resources you need in one place. Use the navigation on the left to quickly find what you're looking for. Be sure to check back frequently for updates.

Prior Authorization and Notification Resources

Current Policies and Clinical Guidelines

Provider Administrative Manual and Guides

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Have questions about UnitedHealthcare Community Plan of Kansas? We have care provider support teams and library of online resources to assist you.

Provider Services Call Center

1-877-542-9235

 

For Credentialing and Attestation updates, complete the online or paper application form.

Disclosure Forms

Disclosure Forms are required for all contracted providers. If you are already a network provider and have not submitted your completed disclosure form, email your form to ks.disclosure.forms@uhc.com

Behavioral Health Providers

Learn how to join the Behavioral Health Network, review Community Plan Behavioral Health information at Community Plan Behavioral Health. Demographic changes should be submitted via the Provider Update Form.

Facility/Hospital-Based Providers, Group/Practice Providers and Individually-Contracted Clinicians

The state-specific requirements and process on how to join the UnitedHealthcare Community Plan network is found in the UnitedHealthcare Community Plan Care Provider Administrative Guide.  

Learn about requirements for joining our network

Kansas Department of Health and Environment's Division of Health Care Finance and the Kansas Foundation for Medical Care (KFMC) are working together to assist Medicaid providers in Kansas with implementing health information technology and the Medicaid EHR Incentive Program (Meaningful Use).

Overview

The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to:

  • Promote quality of care
  • Strengthen efforts to reform the delivery of care to individuals covered under Medicaid and Children’s Health Insurance Plans (CHIP)
  • Strengthen program integrity by improving accountability and transparency

Enhance policies related to program integrity With the Medicaid Managed Care Rule, CMS updated the type of information managed care organizations are required to include in their care provider directories.

Visit UHCCommunityPlan.com/KS for current member plan information including sample member ID cards, provider directories, value-added benefits, dental plans, vision plans and more.

Plan information is available for:

  • UnitedHealthcare Community Plan of Kansas - KanCare 

Member dental plan and benefit information can be found at UHCCommunityPlan.com/KS and myuhc.com/CommunityPlan.

Access a PDF Provider Directory

Baby Blocks Program - Baby Blocks is a web-based, mobile tool to remind and reward pregnant women and new mothers to receive prenatal, postpartum and well-child care.

UnitedHealthcare is alerting our providers that KanCare is beginning its annual Payment Error Rate Measurement Audit (PERM) for claims paid between July 1, 2023 – June 30, 2024.  We ask that you be prepared, if called upon, to provide timely medical records to UHC and KanCare beginning in late fourth quarter 2024.

Payment Error Rate Measurement (PERM) RY25 Audit Medical Records Requests

Beginning in mid to late June, the CMS PERM Audit Review Contractor, Empower AI, Inc., will be requesting medical records from providers whose Medicaid or CHIP Fee-for-Service claims are randomly selected for review.

If one or more of your claims is selected, KDHE will notify you via an announcement letter. Actual medical records requests will arrive at your office directly from NCI, Inc. KDHE staff will be available to answer questions and assist you in meeting submission deadlines.

Providers are encouraged to educate themselves about the PERM program and what is requested of them during the medical records request process by reviewing the material on the CMS Provider website link, Providers | CMS.

 Listed below are some of the available PERM Provider Education downloads and related links:  

Downloads

This PDF provides an overview of the PERM program, a better understanding of the process and what is needed from providers to complete a successful PERM Review.

It also contains provider responsibilities, along with medical record/documentation requests and the Provider Best Practices:  Prior to submitting records, when submitting records, when responding to additional documentation requests, and preventing resubmission.

Related Links

Questions

As providers and if you have questions, please contact:

  • Rebecca Vaillancourt, KDHE PERM Audits Manager                   
    Phone:  785-296-4071
    Email:  Rebecca.Vaillancourt@ks.gov

or:

 

CommunityCare

The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare feature on the UnitedHealthcare Provider Portal, which allows you to:  

  • Identify Medicaid recipients who need to have their Medicaid recertification completed and approved by the state in order to remain eligible to receive Medicaid benefits
  • See a complete list of all members, or just members added in the last 30 days
  • Export the roster to Microsoft Excel
  • View most Medicaid and Medicare Special Needs Plans (SNP) members’ plans of care and health assessments
  • Enter plan notes and view notes history (for some plans)
  • Obtain HEDIS information for your member population
  • Access information about members admitted to or discharged from an inpatient facility
  • Access information about members seen in an emergency department

For help using CommunityCare feature on the UnitedHealthcare Provider Portal, please see our Quick Reference Guide. If you’re not familiar with UnitedHealthcare Provider Portal, go to UHCprovider.com/portal.

When you report a situation that could be considered fraud, you’re doing your part to help save money for the health care system and prevent personal loss for others. If you suspect another provider or member has committed fraud, waste or abuse, you have a responsibility and a right to report it. 

Taking action and making a report is an important first step. After your report is made, we will work to detect, correct and prevent fraud, waste, and abuse in the health care system.

Call us at 1-844-359-7736 or visit uhc.com/fraud to report any issues or concerns. 

UnitedHealthcare Dual Complete® Special Needs Plan

UnitedHealthcare Dual Complete Special Needs Plans (SNP) offer benefits for people with both Medicare and Medicaid. These SNP plans provide benefits beyond Original Medicare, and may include transportation to medical appointments and vision exams. Members must have Medicaid to enroll.

Health Insurance Portability and Accountability Act (HIPAA) Information

HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

Integrity of Claims, Reports, and Representations to the Government

UnitedHealth Group requires compliance with the requirements of federal and state laws that prohibit the submission of false claims in connection with federal health care programs, including Medicare and Medicaid. 

Disclaimer

If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail. To see updated policy changes, select the Bulletin section at left.