Appeals

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This process is for KanCare members who are currently receiving services. KanCare members must complete the appeal process with their managed care organization (MCO) prior to submitting a request for a state fair hearing. With a KanCare appeal (also referred to as an MCO appeal), the Managed Care Organization (Aetna, Sunflower, or United) team will review your case information and any new documentation you send to determine if they agree with you or with the original decision.

A notice of adverse benefit determination is mailed to tell a KanCare member that there has been a change in the KanCare services. It will tell the member that there is an option to appeal the decision.

What is a managed care appeal?
How do I submit a managed care appeal?
Is there a deadline for filing a managed care appeal?
What happens once a managed care appeal has been submitted?
What documents do I need to submit for my managed care appeal?
What happens to my services while I am appealing a managed care decision?
What is an expedited managed care appeal?