KS Provider Information

Care provider content is now available on UHCprovider.com and will retire from UHCCommunityPlan.com later this year. For more information, visit UHCprovider.com/CommunityPlan.

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UnitedHealthcare Community Plan Kansas Providers

UnitedHealthcare Community Plan of Kansas

We insure more pregnant moms, more children, and more aged, blind and persons with disabilities than anyone else. No one has a larger list of doctors and hospitals. We're a leader in working with community organizations to help the uninsured become insured, and the insured to get the best medical care possible. We're a leader in the effort to understand the social and cultural causes of disease. UnitedHealthcare has been in your community for years. We look forward to partnering with you.

KMAP Credentialing / Re-Credentialing Application

Medicaid Managed Care Rule External FAQs (PDF 64.57 KB)
Medicaid Managed Care Rule Presentation (PDF 90.71 KB)

Contact Us

UnitedHealthcare's provider support teams are available to assist Kansas Providers.

View the UnitedHealthcare Community Plan Contact List (PDF 81.3 KB)

Provider Advocate Contact Information

Home and Community Based Service (HCBS) Provider Advocate Map (PDF 224.66 KB)
Provider / Hospital Advocate Team Contact Information (PDF 535.92 KB)
Skilled Nursing Facilities Provider Advocate Map (PDF 107.51 KB)

Report Health Care Fraud, Waste and Abuse: 844-359-7736 or uhc.com/fraud

Issues Log

The Provider Issue Log is updated on a weekly basis and provides the status, resolution and timing of global issues impacting multiple providers.

Access the current Provider Issue Log (PDF 146.34 KB) (issues posted since 2015)

UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan (Dual Special Needs Plan)

View current UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan (Dual Special Needs Plan) Prior Authorization Requirements on UHCprovider.com

Prior Authorization Archive

Click on the arrow above to view the prior authorization archive.

UnitedHealthcare Community Plan Prior Authorization KS - Effective 4/1/2018 (PDF 208.25 KB)

UnitedHealthcare Medicare and UnitedHealthcare Community Plan (Dual Special Needs Plan) Prior Authorization Requirements - Effective 1/1/2018 (PDF 282.37 KB)

UnitedHealthcare Medicare and UnitedHealthcare Community Plan (Dual Special Needs Plan) Prior Authorization Requirements - Effective 10/1/2017 (PDF 286.74 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 10/1/2017 (PDF 220.79 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan (Dual Special Needs Plan) Prior Authorization Requirements - Effective 7/1/2017 (PDF 300.09 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 7/1/2017 (PDF 212.77 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 4/1/2017 (PDF 211.71 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan (Dual Special Needs Plan) Prior Authorization Requirements - Effective 5/1/2017 (PDF 299.55 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan (Dual Special Needs Plan) Prior Authorization Requirements - Effective 1/1/2017 (PDF 306.96 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan (Dual Special Needs Plan) Prior Authorization Requirements - Effective 4/1/2017 (PDF 300.79 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 1/1/2017 (PDF 204.28 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 10/1/2016 (PDF 212.19 KB)

Medical Injectables

Specialty pharmacy medications covered on the Medical Benefit may be provided through a variety of channels – home infusion provider, outpatient facility, physician, or specialty pharmacy.

Medical Injectable Information

Click on the arrow above to view informaiton about medical injectables.

Specialty pharmacy medications covered under the member’s medical benefit may be obtained through various sources ‒ home infusion providers, outpatient facilities, physicians or specialty pharmacy.

If you don’t want to buy and bill a specialty pharmacy medication covered under the member’s medical benefit, you may order it through the following network specialty pharmacy:

Network Specialty Pharmacy	Phone Number
BriovaRx	855-427-4682

The following specialty pharmacies also provide certain types of specialty medications:

Network Specialty Pharmacy	Medication Category	Phone Number
Accredo (nursing services)	Enzyme Deficiency Gaucher's Disease Immune Globulin Pulmonary Hypertension	800-803-2523
Option Care (nursing services)	Enzyme Deficiency Gaucher's Disease Hemophilia Immune Globulin Makena	866-827-8203
CVS Caremark Specialty Pharmacy	Pulmonary Hypertension	800-237-2767

Coverage of a requested medication depends on the member’s benefit, and availability of a specific drug from a network specialty pharmacy may vary.

Upon request, a specialty pharmacy can deliver the medication to your office or another site such as a member’s home.

Medications obtained through a specialty pharmacy will be directly billed to the patient’s health plan.

Disclosure Forms

Disclosure Forms are required for all contracted providers. If you are already a network provider and have not submitted your completed disclosure form, please email the form to ks.disclosure.forms@uhc.com.

Medicaid Provider Assistance

Kansas Department of Health and Environment's Division of Health Care Finance and the Kansas Foundation for Medical Care (KFMC) are working together to assist Medicaid providers in Kansas with implementing health information technology and the Medicaid EHR Incentive Program (Meaningful Use). The documents available at the links below describe the services offered and eligibility criteria.

Medicaid Meaningful Use Incentives (PDF 134.14 KB)

Technical Assistance with Health Information Technology (PDF 453.42 KB)

UnitedHealthcare Community Plan Medical & Drug Policies and Coverage Determination Guidelines

UnitedHealthcare has developed Medical Policies, Medical Benefit Drug Policies and Coverage Determination Guidelines to assist us in administering health benefits. These policies and guidelines are provided for informational purposes, and do not constitute medical advice.
View the guidelines.

UnitedHealthcare Medicare Advantage Coverage Summaries

For policy guidance for Medicare Advantage plan members, view the UnitedHealthcare Medicare Advantage Coverage Summaries Manual and corresponding policy update bulletins here.

Integrity of Claims, Reports, and Representations to the Government

UnitedHealth Group requires compliance with the requirements of federal and state laws that prohibit the submission of false claims in connection with federal health care programs, including Medicare and Medicaid.
View our policy (PDF 38.15 KB).

Disclaimer

If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail. To see updated policy changes, select the Bulletin section at left.