For the best user experience, please view in Landscape mode.
Gainwell Technologies
Medicaid Management Solutions
Medicaid
  • Contact Us
  • Contact Us
  •  Provider Enrollment
    •  New Enrollment
    •  Resume/Revalidate Enrollment
    •  Enrollment Status
    •  Manage Password
    •  Manage Email
    •  Cancel Enrollment
  •  Trading Partner Enrollment
  •  Provider Enrollment
    •  New Enrollment
    •  Resume/Revalidate Enrollment
    •  Enrollment Status
    •  Manage Password
    •  Manage Email
    •  Cancel Enrollment

New Enrollment

  •  Audit
  • Set Panel Tabs
  • MITA Steps
  • Reports & Letters
  • Related Pages
  • View Data
  • Reports
  • Print
  •  Help
Audit
Open in separate window
Mail
Open in separate window
Notes
Open in separate window
Print Preview
Open in separate window
REPORTS
Open in separate window
RTP
Open in separate window
External Links
MESSAGES
@NE TOUCH FAVORITES
Contact Us
Open in separate window
Resolve the following form field errors and try again.
    - :
    Welcome

    "This is a Test region and provider should not submit their application here. if you are seeing this message you are at wrong page and application submitted will never be considered"

    Welcome to the Online Provider Enrollment System

    To start a NEW application please click the “Start” button in the bottom right corner to begin the enrollment process.  The application will automatically save each time you click “Continue”. 

    To RESUME an application click Here

    To start a REVALIDATION click Here

    Enrolled providers: To request a contract with an MCO, Log into the provider secure portal, Navigate to the "Manage my information" section and select the MCO Network tab.

    To check the STATUS of an application click Here

    List of staus descriptions:

      Partial/Started - Application has been started but not yet been submitted or a revalidation* has been generated and requires the provider to complete the revalidation. (*Revalidation is a pre-populated application that needs to be reviewed by the provider and submitted.)

      Awaiting Attachments - Application has been submitted but is waiting for required attachments/documents.

      Submitted - Application is complete and has been submitted for review.

      Pending - Application has been queued for the enrollment team for review.

      RTP (Returned to Provider) - Application requires corrections. (Applicant will receive a separate notification identifying the specific issue(s) requiring attention.)

      Approved - Application has been approved. (Applicant will receive written confirmation that the application has been approved. For newly-enrolling Providers, the Welcome Packet includes the Provider number and other program participation information.)

      Expired - Application was not submitted within the allowable timeframe. A new application is required in this situation.

      Submitted to Managed Care - Application has been forwarded to MCOs for contracting. (This status is used for KMAP-approved applications that have also requested to participate with additional managed care organizations.)

    Please note that only one service location and one provider type can be enrolled per application.  All attachments must be complete, legible and current.  You will be notified if your application cannot be processed because it is incomplete or the information is incorrect.

    Existing Group members (Individuals in a Group) only need to be enrolled once for each state in which they practice.  Individual in a Group providers may affiliate to multiple organizations.

    All providers may need the following minimum information to complete your enrollment request:

    • Address information
    • Tax Identification Number/Social Security Number
    • W-9
    • Application Fee

    Additional information may also be required depending on provider type such as:

    • National Provider Identifier
    • Taxonomy code(s)
    • License Number(s) and Effective Dates
    • CLIA Number and Effective Dates – if billing laboratory codes

    For general enrollment Frequently Asked Questions, click Here

    For any questions related to your application, call 800–933–6593.

    Enrollment Pre-Checklist

    "WARNING: You have reached the KMAP testing environment. Any information found may not be accurate."

    Please select the below parameters to generate a checklist enlisting the credentials and documents required to complete an enrollment application. All the credentials that are furnished in the application must be current. Future dated or expired credentials will cause your application to be returned.
    Generate Pre-Checklist
    Registration

    Register below to be assigned a unique enrollment tracking number. Be sure to write down your password. An email confirmation will be sent with the tracking number. If you don't submit your enrollment right away, you can use this tracking number and password to resume your enrollment application later.

    General
    Initial Enrollment Information
    Provider Information
    The Provider Name must be the current name on tax, corporation, or other legal documents. The legal name and Provider Federal Tax Identification Number (TIN) must match the information on the W-9 for businesses and Internal Revenue Service records for individuals.

    -

    -

    -

    If this application is for enrollment into the Fee-for-Service (FFS) program only. It will not be shared with the other state Managed Care Organizations. You will need to apply directly to each MCO program once your FFS application is approved. Your answer to the question below is strictly for informational purposes. Please select the appropriate option
    Please select the programs to which you are applying. You must choose at least one program.
    General Credential Information
    Please list the other names under which you have been known.
    IDNameFirst NameMiddle Name Effective DateEnd DateEdit
    Please select your place of birth.
    Contact Information
    Home Address
    DISCLAIMER

    The website is provided as a convenience to providers, members and stakeholders of Kansas Medical Assistance Program. Despite our best intentions to maintain complete and accurate information, discrepancies may sometimes occur and materials on the site may not be consistent or up-to-date with current program guidelines. If in doubt, please contact Customer Service.

    Back to Top
    WEBSITE REQUIREMENTS

    PRIVACY AND SECURITY

    When logging in to the application for the first time, you may be asked if you are using a personal or a public computer. Please use caution while answering this question as the privacy and security required to protect healthcare data could be impacted by your selection.


    BROWSER SUPPORT AND TESTING

    The Gainwell Technologies Medicaid Management Solutions and Healthcare Portals support browsers meeting the World Wide Web Consortium (W3C) Hypertext Markup Language (HTML) 5 specification. Support is based solely on HTML 5 compatibility regardless of other factors, such as browser market share.

    Gainwell develops code to conform to the HTML 5 standard and compatibility is confirmed through rigorous testing. The Gainwell testing team conducts verification of product developed pages against Microsoft Edge, Google Chrome, and Safari. In the event a defect is identified, by Gainwell or a client, it will be evaluated and managed via the product defect management process.

    The browser support of various commercial off-the-shelf (COTS) tools, such as workflow, business rules engine, or file transfer systems is based on the browser capabilities defined by the specific software vendor.

    As the HTML 5 specification evolves, Gainwell will support minor version updates within one year of release. The current specification is HTML 5.2 and was published on 12/14/2017.


    ACCESSIBILITY AND AMERICANS WITH DISABILITIES ACT (ADA) COMPLIANCE

    Gainwell is committed to making its electronic and information technologies accessible to people with disabilities. We strive to meet or exceed the requirements of Section 508 of the Rehabilitation Act (29 U.S.C. 794d), as amended in 1998 as well as the Web Content Accessibilities Guidelines (WCAG) Version 2.1.

    Section 508 is a federal law that requires agencies to provide people with disabilities equal access to electronic information and data comparable to those who do not have disabilities, unless doing so would impose an undue burden on the agency. The Section 508 standards are the technical requirements and criteria used to determine whether the agency is meeting the requirements of this law.

    The Web Content Accessibility Guidelines (WCAG) are part of a series of web accessibility guidelines published by the Web Accessibility Initiative (WAI) of the World Wide Web Consortium (W3C), the main international standards organization for the Internet. They are a set of recommendations for making Web content more accessible, primarily for people with disabilities—but also for all user agents, including highly limited devices, such as mobile phones. WCAG 2.0, was published in December 2008 and became an ISO standard, ISO/IEC 40500:2012 in October 2012. WCAG 2.1 became a W3C Recommendation in June 2018.


    SCREEN RESOLUTION

    It is recommended that screen resolution should be a minimum of 1024 x 768.


    DOCUMENT VIEWING AND DATA EXPORTS

    Some features within the product produce information in either pdf or xls format. For viewing of this information, Adobe Acrobat and/or a Microsoft Office viewer may be required.


    COOKIES

    Like most commercial websites, the product may also use what is known as "cookie" technology. A "cookie" is an element of data that a website can send to your browser when you link to that website. It is not a computer program and has no ability to read data residing on your computer or instruct it to perform any step or function. By assigning a unique data element to each visitor, the website can recognize repeat users, track usage patterns and better serve you when you return to that site. The cookie does not extract other information about you, such as your name or address.

    Back to Top
    PRIVACY POLICY

    Enterprise Online Privacy Statement


    PRIVACY AND DATA PROTECTION AT PORTAL WEBSITES

    This policy has been updated to protect personal data in accordance with requirements set forth in the General Data Protection Regulation (GDPR), which took effect on May 25, 2018. At Medicaid HealthCare Payer Portal websites our commitment to privacy goes beyond the minimum legal and regulatory requirements. We strive for best-in-class data protection and privacy management, which requires a sound data privacy governance structure and an effective data privacy compliance and best practices program to ensure we meets ever-changing and increasingly-complex regulatory standards and all contractually agreed privacy obligations. Medicaid HealthCare Payer Portal websites Global Privacy and Data Protection Office has strategic and operational responsibility for this program, which is adequately resourced and appropriately organized to ensure the policies and compliance processes, technology and physical controls and security we rely upon to govern the collection, use, storage and transfer of personal data all over the world meets statutory and regulatory requirements. Therefore, Medicaid HealthCare Payer Portal websites approach is to coordinate the contribution of several corporate disciplines - including ethics and compliance, legal, human resources, and information and physical security - to achieve our "best in class" data protection and privacy management objectives.

    Back to Top
    Disclaimer Website Requirements Privacy Policy
    © 2024 Gainwell Technologies. All rights reserved.
    Server: 30.201.181.82 Build Date: 11/7/2024 9:03:37 AM v22.2.124.36
    Processing...