Provider Publications
~/ProviderPricing/ProviderPublications
Provider Bulletins
~/Public/Bulletins
Forms
~/ProviderPricing/ProviderPublications#prvForms
Manuals
~/Public/ProviderManuals
HIPAA Guide
~/ProviderPricing/HIPAACompanionGuides
Member Publications
~/Public/MemberPublications
Publications

 

Provider Manuals

The Provider Manuals page is divided into two sections: Current Manual Type and Discontinued Manual Type. Both current and discontinued manuals have historical versions available. All discontinued manuals no longer contain active information and are strictly available for historical purposes. The latest version of the current manual contains the most up-to-date information. Search manual types alphabetically by clicking on the arrow to the right of the drop-down box.

Forms
Bulletins
Provider Enrollment Applications

Thank you for your interest in becoming a Kansas Medicaid Provider. Use the links below to start a new application or to complete a revalidation.


Start a New Online Application or Revalidation


Other forms that may be required to complete an enrollment can be found here


Provider Enrollment Help and Information


Enrollment Wizard Tips


The links below contain details of the required attachments for all applications displayed by provider type.



Enrollment Applications - Enrollment Requirement Documents

PT 01 - Hospital
PT 20 - Audiologist
PT 24 - Pharmacy
PT 08 - Clinic
PT 27 - Dentist
PT 17 - Therapist
PT 19 - Optician
PT 56 - WORK
Training Materials

 

DocumentDate Posted