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Kansas HealthWave 19 and 21
PW_A085536
Welcome to our State Sponsored Health Plans
Kansas Provider Resources and Contracting Materials
We're dedicated to HealthWave (Medicaid and Children’s Health Insurance Program) populations and those who serve them.
Learn more about our programs.
We invite you to join us. Call today to speak with a member of our provider recruiting team at 1-877-604-0462.
The following "State Sponsored Business Practice Information" documents are available for download:
Recruiting and Contracting Materials
CMS Ownership Disclosure Form
Request for Professional Provider Practice Information (Contract Application)
Provider Recruiting Information
Provider Communications
How to Access Preventive Care Forms Online.
CHIPRA, February 2009
Desktop IVR Reference Guide
Provider Newsletters
Provider Bulletins
Quality Improvement Program Available for Providers Upon Request
Programs and Services
EPSDT HealthWave Kan Be Healthy Information
Health Education Programs
Pharmacy
Interpreter Services
Policies, Manuals, and Guidelines
Advanced Directives
Unicare Medical Policies
Clinical Practice Policies
Preventive Health Care Guidelines
Member Handbook/Evidence of Coverage (PDF)
Provider Directory (PDF)
Provider Operations Manual and Important Updates
Provider Fee Schedule (PDF)
This is a base schedule of covered benefits and does not imply any specific contractual arrangements or billing formats.
20 Principals of Customer Care (PDF)
HEDIS® Descriptions
(PDF)
HEDIS Measure Physician Documentation Guidelines and Administrative Codes
(PDF)
Prior Authorization and Preservice Review
Prior Authorization Toolkit
Request for Preservice Review
Services Requiring Prior Authorization
Specialty Pharmacy Infused/Injectable Forms
Specialty Pharmacy Infused/Injectable Drug Prior Authorization List
Forms and Tools
Forms and Tools Library
EFT/ERA Enrollment Form
Notice of Privacy Act (PDF)
Physician Appeal Process for Medical Necessity or Experimental/Investigational Adverse Determinations (PDF)
Clinical Utilization Management Guidelines (PDF)
Urgent Care Clinic List
National Provider Identifier (NPI)
URGENT NOTIFICATION This Message Affects Claims Submitted for Medicaid Services Medicaid Claims without Appropriate NPI will Deny Effective December 1, 2008
NPI: Professional 837 Enumeration and Contractual Chart
NPI: Institutional 837 NPI Enumeration and Contractual Chart
National Provider Identifier Fact Book
NPI FollowUp on Key Items
NPI and How to Submit Claims
