The Kansas Department of Health and Environment has announced the selection of three managed care organizations that will serve the Kansas Medicaid program, known as KanCare, from January 1, 2025 to December 31, 2027.
The KanCare program currently serves 458,000 individuals throughout the state.
The contracts include two incumbents, Sunflower Health Plan and United Healthcare Community Plan, and one new organization, Healthy Blue.
For more information about KanCare, visit kancare.ks.gov.
The upcoming qualifying period ends November 30th for the every 90 day attestations confirming accurate provider data on file at Blue Cross and Blue Shield of Kansas (BCBSKS) through the Provider Portal. To access the Provider Portal, sign in through Availity.com, and select BCBSKS under payer spaces.
Attesting to your provider demographics timely will ensure your QBRP incentive remains effective. This information is used in provider directories, network adequacy reporting, and other down-line operations within the health plan, adding to the importance of the data remaining current.
Address:
613 N. Broadway
Suite F
Pittsburg, KS 66762
Phone Number:
620-231-7600
Fax Number:
620-231-7602
Board Meeting Dates and Location:
613 N. Broadway, Suite E
Pittsburg, Kansas 66762
12:15 pm
April 29, 2025
July 29, 2025
October 28, 2025
Contact the office today if you are interested in an uptodate subscription offered to our membership.
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What can we help with:
Our Preferred Community Choice
PPO contract will end on 02/28/2025
due to a decline of members in this
area.
Validate and Reattestation
Payers are requiring groups and providers to validate and re-attest demographic information more often. We will make sure your information is always up to date with each payer and attested so there is no gap in coverage. Below is a list of some of the maintenance completed quarterly and annually.
PROVIDER ENROLLMENT
Healthcare providers must regularly update their information with payers — such as changes in practice location, staff, or licensure status — and ensure timely re-enrollment. We can manage these tasks for you!
Our credentialing process generally takes between 60-90 days. When you sign up for credentialing with us, we waste no time getting your applications completed and submitted to insurance companies. We follow up regularly with insurance companies to make sure that your credentialing applications are processed and approved as soon as possible. Most of our contracts are delegated so your enrollment is fast!
We have over 27 years of experience in provider credentialing and payer enrollment and the credentialing is done by a certified provider credentialing specialist. We also offer Medicare and Medicaid provider enrollment and revalidation as well as enrollment with Kansas, Missouri and Oklahoma Medicaid and their MCOs. We comply with NCQA regulations.
Medical Billing Services
We now offer billing and claims submission!
Contact Kayla Piper at billing@pinnaclecarepho.org for more details.
We are excited to share that we now offer notary services. Email Kayla Piper at billing@pinnaclecarepho.org or call (620) 670-6621 to schedule an appointment.