All providers wishing to enroll with an MCO must now access the application through the Provider Enrollment Wizard. This is the same application used to apply directly with Kansas Medicaid. To provide more detail, review the Provider Enrollment Guide here. This resource guide is intended to provide clarification and updates to the provider enrollment requirements for Kansas Medicaid Providers.
To ensure a broad base of providers, we encourage providers to enroll with each of the KanCare plans. Due to the Managed Care Organization health plan regulations, enrollment with KMAP is required. However, while enrollment in KMAP is required, seeing Fee For Service members is not mandated. The KanCare health plans must pay at least 100 percent of the current fee-for-service Medicaid rate (as of 11/9/12) to all contracted, in-plan providers. The rate cannot decrease for the life of the KanCare contracts. You can negotiate a different reimbursement structure if you would like to do so. If you do not sign up with the KanCare health plans, you will be considered an out-of-network provider. Out-of-network providers will receive 90 percent of the current fee-for-service rates.
Applications for facilities, hospitals and HCBS providers as well as behavioral health providers are available at the Enrollment wizard page.
Additional Information
If you wish to credential/contract with the KanCare MCOs, select the MCOs you wish to be credentialed/contracted with as you complete your application. Only one application is needed, the information will be shared with the MCOs chosen. As of July 1, 2019, the KanCare MCOs started denying payments for providers who are not actively enrolled with KMAP.
How does my application get to the MCOs?
During the enrollment process, you will select which MCO(s) you wish your application and supporting documentation to be sent to for use in the MCO credentialing and contracting process. Once your enrollment with KMAP is approved, the application and all supporting documentation will be sent to a portal for retrieval/download by the MCOs.
I’m already enrolled with KMAP, when should I provide my existing KMAP ID?
Please provide your existing KMAP ID in the appropriate box. You will be asked to provide your current (active) provider ID or previous (inactive) provider ID.
The following health plans or managed care organizations (MCOs) were awarded contracts to provide KanCare services:
- Sunflower Health Plan
- UnitedHealthcare Community Plan of Kansas
- Aetna Better Health of Kansas (Available to members January 1, 2019)