Full Answer
Why choose sunflower health plan?
At Sunflower Health Plan we understand how important you and your family's healthcare needs are. It's important to us too. As your KanCare health plan provider, we are here to support your health needs and make your day easier.
What is sunflower Health Plan’s email policy?
Sunflower Health Plan does not accept responsibility or liability for any loss or damage arising from the use of email.
Is sunflower health plan a KanCare plan?
As a KanCare health plan, Sunflower Health Plan is a provider of Kansas Medicaid. Our members receive benefits and services from Sunflower Health Plan's network of providers. Learn more about Sunflower’s KanCare insurance plan services and enroll today.
What types of claims does sunflower accept?
Sunflower accepts electronic claims, claims submitted through our Secure Provider Portal or claims submitted through KMAP. Sunflower uses payer ID number 68069. Our preferred electronic claims warehouses are: SSI, Gateway, Emdeon, Availity, and Smart Data Solutions.
Who qualifies for Medicaid Kansas?
Be responsible for a child 18 years of age or younger, or. Blind, or. Have a disability or a family member in your household with a disability, or. Be 65 years of age or older.
What does Kansas Medicaid cover for adults?
These include physical health services such as doctor appointments and hospital visits, behavioral health services, dental and vision care, pharmacy, transportation, and nursing facility care. All the services offered through the State's Home and Community Based Services waivers are part of KanCare.
Does Kansas Medicaid cover braces?
The answer is yes! If braces are deemed medically necessary for your child, Medicaid can assist in getting them.
How do I contact Kansas Medicaid?
Contact UsKanCare (800-792-4884) (Clearinghouse) ... Managed Care Enrollment Center (866-305-5147) ... KanCare Eligibility Families and Children (800-792-4884) ... KanCare Eligibility Elderly and Persons With Disabilities (800-792-4884) ... Premium Billing: (866-688-5009) ... Aetna Customer Service (855-221-5656)More items...
Does Kansas Medicaid cover dentures?
Dentures are covered for eligible members receiving Frail & Elderly Waiver benefits. Eligibility is based on medical necessity. Any member over age 21 can visit a participating dental provider once a year for a screening and cleaning, which includes scaling and polishing teeth.
Does Medicaid cover vision and dental?
States are not required to offer dental, vision, or hearing services to adult Medicaid enrollees. Even in states that offer some coverage, enrollees' access to care is inconsistent: the scope of the benefits varies widely between states, and states often cut these benefits when facing budget shortfalls.
What dental services are covered by Medicaid?
What Dental Services Does Medicaid Cover?Restorative Care.Oral Surgery.Dental Emergencies.Orthodontic Braces.Preventive Dentistry.Periodontal Treatment.Cosmetic Dentistry.
Does Medicaid cover Invisalign?
While Medicaid does cover some orthodontic procedures for qualifying patients, Invisalign treatment is considered a cosmetic procedure and is not covered.
Does Medicaid cover teeth whitening?
In most cases, Medicaid does not cover cosmetic dentistry. Does Medicaid cover teeth whitening? Medicaid does not cover teeth whitening, however, this service can still be paid for out of pocket at our office.
Does Kansas have state health insurance?
What is KanCare? The program for Medicaid in Kansas is called KanCare. KanCare offers health insurance coverage for children, pregnant women, families with children, elderly, and adults and children with disabilities in the state of Kansas.
How do I pay my KanCare premium?
How do I pay my premium? You have several choices: • Mail: Send a check or money order to the payment address below. automated service by calling 1-866-923-2724. To speak with a payment agent you can call 1-866-688-5009.
What is the difference between Medicare and Medicaid?
The difference between Medicaid and Medicare is that Medicaid is managed by states and is based on income. Medicare is managed by the federal government and is mainly based on age. But there are special circumstances, like certain disabilities, that may allow younger people to get Medicare.
How do I submit claims to Sunflower?
Sunflower accepts electronic claims, claims submitted through our Secure Provider Portal or claims submitted through KMAP.
What criteria does Sunflower use to make authorization decisions?
Sunflower has adopted utilization review criteria developed by McKesson InterQual® products to determine medical necessity for healthcare services. InterQual appropriateness criteria are developed by specialists representing a national panel from community-based and academic practice.
Will Sunflower post the new codes and payment schedule on their website for behavioral health providers?
Can a behavioral health provider submit claims through the Sunflower website?
Who is eligible for care management?
If a member is receiving Home and Community Based Services (HCBS), Work Opportunities Reward Kansans (WORK), Children and Youth with Special Health Care Needs ( CYSHCN), they will automatically enroll in care management.
How can a provider request or contact a care manager?
Providers may make the request through the secure portal. They may also call Customer Service at 1-877-644-4623 and request a care manager or ask to speak with a representative of the Care Management department. You may also access the Medical Management Territory Map that is located under Provider Resources. The map provides an email address for someone in the county where the member resides.
Do providers need a Kansas Medicaid ID number to be paid or to be contracted with Sunflower?
Yes, all providers must have a KMAP ID to obtain a contract with or receive payment from Sunflower Health Plan.
Do I have to be credentialed by Sunflower in order to become a contracted provider?
Yes, you must be credentialed by Sunflower. Upon your written authorization, Sunflower will access your credentialing information on the CAQH (Council for Affordable Quality Health) website. Sunflower will also use the Kansas Final Joint Approved Credentialing Application for hospitals and ancillary providers. These documents will be included in the contract packet sent to you by Sunflower.
How to contact Sunflower Health Plan?
The Contact Us form will send your message to Sunflower Health Plan as an email. The email is not encrypted and is not transmitted in a secured format. By communicating with Sunflower Health Plan through email, you accept the risks associated thereof. Sunflower Health Plan does not accept responsibility or liability for any loss or damage arising from the use of email. To ensure the safety of your protected health information (PHI), please send us a message through the Secure Member Portal or Provider Portal, or you can call us at 1-877-644-4623 to speak directly to a customer service representative.
Does Sunflower Health Plan take responsibility for email?
Sunflower Health Plan does not accept responsibility or liability for any loss or damage arising from the use of email. To ensure the safety of your protected health information (PHI), please send us a message through the Secure Member Portal or Provider Portal, or you can call us at 1-877-644-4623 to speak directly to a customer service ...
