KS Provider Information

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)
UnitedHealthcare Community Plan Added to Electronic Payments & Statements (PDF 59.89 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

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 (issues posted since 2015)

Find A Doctor 

Access our online provider search tool  

Provider Directories  

Eastern Kansas Provider Directory (PDF 3.04 MB) - posted 3.22.2018
Nothern Kansas Provider Directory (PDF 2.49 MB) - posted 3.22.2018
Southern Kansas Provider Directory (PDF 3.27 MB) - posted 3.22.2018
Western Kansas Provider Directory (PDF 1.99 MB) - posted 3.22.2018
Home and Community Based Service (HCBS) Provider Directory (PDF 3.25 MB) - posted 3.22.2018

Prior Authorization

UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan
UnitedHealthcare Medicare Prior Authorization Requirements - Effective 4/1/2018 (PDF 293.21 KB)

UnitedHealthcare Community Plan
UnitedHealthcare Community Plan Prior Authorization KS - Effective 7/1/2018  (PDF 552.56 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.

Provider Notice Archives 

DME Notice for Pharmacies (PDF 90.14 KB) 

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)

HPV Home

http://www.cdc.gov/hpv/index.html

The HPV Home site is the CDC website for the public and health care professionals. Healthcare professional information includes:
• CME opportunities
• Fact Sheets and schedules
• Tools and materials for your office
• Information to provide to parents (English/Spanish)
• Recommendations for leading the conversation about HPV

HPV for Clinicians CE
http://www.cdc.gov/hpv/hcp/continuing-ed.html

The HPV Clinicians for CE link is a CDC website with free, credit courses on HPV infection, cancers and vaccinations. The courses include guidance on how to have an effective conversation with parents about HPV vaccinations.

You Are The Key to Cancer Prevention! Vacinate!  http://www.kansasaap.org/wordpress/chapter/kaap-webinars/hpv-webinar/

You Are the Key to Cancer Prevention! Vacinate! is presented as a web-on-demand video with pre-test and post-test. 

Physicians: 
The Kansas Chapter, American Academy of Pediatrics is accredited by the Kansas Medical Society to provide continuing medical education for physicians.

The Kansas Chapter, American Academy of Pediatrics designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)^TM.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

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.