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Medical Policy and Clinical UM Guidelines

View our medical policies and clinical UM guidelines

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Kansas HealthWave 19 and 21

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Provider Resources

Provider Training

   
   
     

Recruiting and Contracting Materials

Date

Format

We're dedicated to HealthWave 19 and 21 populations and those who serve them. We invite you to join us. Call today to speak with a member of our provider recruiting team at 1-877-604-0462. As an additional resource, here is a list of Important Contact Information.

   
05/11 
PDF 

Summary of Provider Credentialing Program

04/10

PDF

Learn More About Our Programs

03/06

PDF

Provider Recruiting Information

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-

Request for Professional Provider Practice Information (Contract Application)

09/27/08

Word

CMS Ownership Disclosure Form

03/02/10

PDF

EFT/ERA Enrollment Form

10/14/10

PDF

     

Quality Improvement Program

Date

Format

QIP Summary

01/10

PDF

HEDISĀ® Descriptions

09/09

PDF

HEDIS Measure Physician Documentation Guidelines and Administrative Codes

11/09

PDF

20 Principals of Customer Care

10/06

PDF

Clinical Practice Guidelines

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Preventive Health Care Guidelines

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Behavioral Health Clinical Practice Guidelines

   
     

Prior Authorization and Preservice Review

Date

Format

Services Requiring Prior Authorization

08/16/11

PDF

Request for Preservice Review

10/10/11

Word

UM Clinical Guidelines

01/12

PDF

     
Please contact the UM intake department for any questions on prior authorization at 866-408-7107 or fax 866-408-7194 

Health Education

Date

Format

   

Employee Language Skills Self-Assessment Tool

09/07/12

PDF

Prenatal Program

-

-

UniCare Cultural Competency Toolkit

04/10

PDF

EPSDT HealthWave Kan Be Healthy Information

-

-

Health Education Programs

-

-

Interpreter Services

-

-

Interpreter Services Desktop Reference

-

PDF

UniCare Non-Emergent Medical Transportation

-

PDF

11/11/11

PDF

     

Provider Communications

Date

Format

Provider Operations Manual and Important Updates

-

-

Provider Newsletters

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-

CHIPRA, February 2009

02/09

PDF

     
Additional Programs and Services 

Date

Format

Pharmacy Information

-

-

Specialty Pharmacy Infused/Injectable Drug Prior Authorization List

02/06/09

PDF

     

Forms and Tools

Date

Format

08/12

PDF

03/12

PDF

09/11

PDF

03/12

PDF

04/11

PDF

03/11

PDF

Benefits Matrix for HealthWave 19 and 21 Members

-

PDF

Forms Library

-

-

How to Access Preventive Care Forms Online

-

PDF

Desktop IVR Reference Guide

03/09

PDF

Member Handbook/Evidence of Coverage (PDF)

01/01/09

PDF

Provider Directory (PDF)

04/10

PDF

Urgent Care Clinic List

01/12

PDF

     
Standards and Policies 

Date

Format

Notice of Privacy Act

04/07

PDF

Understanding Fraud & Abuse

03/01/10

PDF

Advanced Directives

07/01/09

PDF

UniCare Medical Policies

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