- Provider Information
- Appeals, Grievances and State Fair Hearings Information
- Claims and Member Information
- Claim Reconsideration and Appeals
- Clinical Practice Guidelines
- Cultural Competency Library
- Dual Complete (HMO-POS SNP) Program
- Electronic Data Interchange (EDI)
- Pharmacy Program
- Provider Admin Guides
- Provider Forms
- Reimbursement Policy
- Value Added Benefits for Members
Prior Authorization Form
Providers can use the Prior Authorization Form (PDF 228.04 KB) to fax in a prior authorization request.
Primary Care Physician (PCP) Change Request Form (PDF 231.42 KB)
Primary Care Physician (PCP) Lock-In Referral Form (PDF 65.39 KB)
Provider Demographic Change Form
Use the Provider Demographic Change Form (PDF 401.58 KB) to submit or to make changes to your demographics like address, phone number, change in practice name, adding a physician, etc. The form also includes instructions on how to submit the form when it's completed.
Unsolicited Refund Process
Learn more (PDF 27.47 KB) about the process on how to submit unsolicited refunds to UnitedHealthcare Community & State for the KanCare program.