We strive to make information readily available to your office. We understand that your office is affected by any changes to the contracts that you hold through Mercy Managed Care. In efforts to keep you updated, this section is designed to update you on contract information including: new contracts, contract terminations, rate updates, TPA changes, and miscellaneous other news.

Please be aware that not all rate changes or contract updates below will necessarily pertain to everyone. We are also not able to publish specific rate information online as that data is confidential. Please see the additional resources below that are available to you to confirm specific contract participation.

• Mercy Network LLC providers: If you are participating with Mercy via a contract with Mercy Network LLC (this would include providers in Southwest Missouri,  Northwest Arkansas, Oklahoma and select providers in St. Louis), please reference your online matrix for specific contract participation.
• Mercy PHO providers: If you are contracted with Mercy via the Mercy PHO (this would include the majority of providers in the St. Louis region), please reference your PHO contract and enrollment packet for a listing of the contracts you hold through Mercy.
• Mercy employed/integrated providers in the St. Louis region: Please continue to reference the Managed Care hub on Baggot Street, and the Sharepoint site as your reference for contract participation.
• All other Mercy employed/integrated providers: Please continue to use the Managed Care hub on Baggot Street as your reference for contract participation.

Provider Changes
As a contracted provider, it is important to notify us immediately of changes to your practice such as: a new provider joining the practice, changes in billing information, provider leaving the practice, or adding a new clinic location.  Notification may help avoid claim denials.  Please submit changes by fax 417-820-3821 or email. Please include a W-9 Form if the change involves a new billing address or tax identification number.

Here are this week’s bulletin topic from the Kansas Medical Assistance Program (KMAP). Visit our provider news page to see Sunflower bulletins and other news.

KMAP BULLETIN: FFY 2018 PAYMENT RATES
Effective with dates of service on and after October 1, 2017, hospice services will be reimbursed in accordance with the federal fiscal year (FFY) 2018 policy. The rates are based on provider submission of required hospice quality data in accordance with Section 3004 of the Affordable Care Act. Read more …

KMAP BULLETIN: HCPCS OCTOBER 2017 UPDATES
Effective with dates of service on or after October 1, 2017, additional procedure codes will be covered. Read more …

KMAP BULLETIN: PRIOR AUTHORIZATION REQUIRED FOR MEDICATIONS
Effective with dates of service on and after October 17, 2017, additional medications will require prior authorization. Read more …

October 25: Provider Training Workshop in Wichita. We still have availability for this valuable training opportunity!

HealthChoice TPA Updates 101317

Please see attached letter from Cigna regarding changes to their drug formulary going into effective on January 1, 2018.

Cigna – Drug Formulary Changes 010118

providers news – september 2017

Anthem Network Update October 2017

Here are this week’s bulletin topic from the Kansas Medical Assistance Program (KMAP). Visit our provider news page to see Sunflower bulletins and other news.

KMAP BULLETIN: ANNUAL ATTESTATION REQUIREMENT
Provider or provider entities receiving payments in any federal fiscal year (October 1 to September 30) of at least $5 million from the Kansas Medical Assistance Program (KMAP) and KanCare managed care organizations (MCOs) are subject to the provisions contained within Section 6032 of the Deficit Reduction Act of 2005 (Pub. L.109-171). Read more …

KMAP BULLETIN: OTHER INSURANCE VERIFICATION
The State has implemented an automated insurance verification process to provide accurate and timely other insurance policy information to the provider network. This Cost Avoidance Verification (CAV) process provides validated third-party liability (TPL) policy information to the fiscal agent for claims processing. The validated policies are systematically reviewed and the appropriate data is identified and automatically updated in the Medicaid Management Information System (MMIS). This process has been in production since May 2017. Read more …

KMAP BULLETIN: MS-DRGS GROUPER VERSION 35
The Medicare Severity Diagnosis-Related Groups (MS-DRGs) Grouper Version 35 will be installed and ready to use for claims processed on and after October 1, 2017. The Hospital DRG and provider specific weights and rates update will occur separately on January 1, 2018. Read more …

FROM KDHE:
New KS-Train platform – The Kansas Department of Health and Environment’s (KDHE) learning management system received an upgrade Thursday, Sept. 28.

KS-Train services over 82,000 professionals. The system used to train KDHE employees, public health officials, emergency responders, environmental practitioners, healthcare professionals, child care providers, and many other professions across the state of Kansas can be found at the new web address: https://www.train.org/ks/. Some key new features are a new, more intuitive layout, the ability to use the website on a mobile device and interoperability between different types of web browsers. All learning records from the original platform have be transferred and accessible.

For more information on the new site, access online tutorials. If users have questions or concerns, they can contact Debbie Nickels at 785-291-3457 or .

aetna update 092617

Here are this week’s bulletin topic from the Kansas Medical Assistance Program (KMAP). Visit our provider news page to see Sunflower bulletins and other news.

KMAP BULLETIN: WORK PROGRAM MANUAL
In keeping with current policy and procedures, the updated Work Opportunities Reward Kansans WORK Program Manualis available on the Kansas Department of Health and Environment (KDHE) website. A link to the updated manual is on the Provider Manuals page of the Kansas Medical Assistance Program (KMAP) website under Work Opportunities Reward Kansans in the Current Manual Type drop-down box. For additional information about the Working Healthy program, reference the Working Healthy page of the KDHE website.

REMINDER: We’ll be in Colby, KS, on September 28 for two provider workshops. Click to learn how you can attend!

Cigna 2017 Kansas Missouri Reference Guide

This will be an all managed care organization (MCO) collaborative session providing training for all providers. In addition to the training, each MCO will be available in breakout sessions all day.

Topics include:

• How to work with MCO provider services
• How to verify member eligibility
• Third-party liability verification
• Covered services
• Prior authorization
• Top 10 claim denials and how to address
• Member billing rules
• Reconsiderations, appeals, and state fair hearings
• MCO value added benefits
• NEMT benefits
• MCO care coordination

Register on the Workshop Schedule page of the KMAP website.

The morning and afternoon sessions are identical. Please select the time that works best for you. Preregistration for one specific session is required.

KanCare All MCO Training – Wichita

• Date: Tuesday, October 17, 2017
• Training site: DoubleTree by Hilton Wichita Airport
  • 2098 Eisenhower Airport Parkway
  • Wichita, KS 67209
• Capacity: 250 participants
• Option 1: 8:00 – 11:45 a.m.
• Option 2: 1:00 – 4:45 p.m.

KanCare All MCO Training – Olathe

• Date: Tuesday, October 24, 2017
• Training site: Ball Conference Center
  • 21350 West 153rd Street
  • Olathe, KS 66061
• Capacity: 225 participants
• Option 1: 8:00 – 11:45 a.m.
• Option 2: 1:00 – 4:45 p.m.

The training materials are available on the Training Materials page of the KMAP website for providers to review prior to the session. Please print a copy and bring it with you if you would like to have a copy to use while attending the training.

For questions or assistance, contact one of your MCO representatives who will be happy to assist you. Thank you for your participation.