Kansas contracts with three health plans, or managed care organization (MCOs), to coordinate health care for nearly all Medicaid members through the KanCare program. The KanCare health plans are Healthy Blue, Aetna Better Health of Kansas, Sunflower State Health Plan and UnitedHealthcare Community Plan of Kansas.
Each Medicaid Member may be assigned to one of the KanCare health plans. Members in KanCare will receive all the same services provided under the previous Medicaid delivery system, plus additional services. The KanCare health plans are required to coordinate all of the care a member receives.
For KanCare information and assistance in choosing a Managed Care plan call 1-866-305-5147. Enrollment specialists are available to answer any questions you have and to help you enroll over the phone.
The Kansas Department of Health and Environment Division of Healthcare Finance maintains a KanCare website at (Kancare). The KanCare website maintains a current list of consumer benefit coverage plans included in KanCare.
The State of Kansas contract with Amerigroup expired December 31, 2018. Amerigroup maintained a local office to assist with the transition out of the Kansas market through March 31, 2019. As of April 1, 2019, all Kansas emails and phone numbers are no longer in service. Providers must call the national provider assistance line at 1-800-454-3730 for assistance.
Providers have an ongoing contractual relationship which survives the KanCare contract termination. Providers should use the terms of that contract for resolution of any issues or disputes. Depending upon the contract, normal provider disputes would follow the reconsideration, appeal, and fair hearing pathway to resolve issues. Important to note, Amerigroup will consider a group appeal for the same issue. Providers can reference the claims appeal form on the website below for instructions on how to do multiple claim appeals.
The bottom of the following website displays Amerigroup guidelines, as well as any forms which may be required:
https://www.kancare.ks.gov/providers/health-plan-information.
If a provider has followed these procedures and still needs assistance, they can email KanCare at KDHE.KanCare@ks.gov with appeal/fair hearing information, the amount in dispute, and a description of the issue.
