Log in to BlueAccess Step two Begin your search Step three View search results Primary doctor/hospital search Search for an in-network doctor, hospital or health care provider. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All Register here. Blue Shield Association. The Blue Cross and Blue Shield and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. As the nation's second largest health plan-owned company, Anthem Behavioral Health provides choice, innovation and access. Become a Provider. rights reserved.CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc., which are independent licensees of the Blue Cross and Blue Shield Association. If you wish to credential/contract with the KanCare MCOs, select the MCOs you wish to be credentialed/contracted with as you complete your application. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All To provide more detail, review the Provider Enrollment Guidehere. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All rights reserved.BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association. Only one application is needed, the information will be shared with the MCOs chosen. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All Claim Forms. All providers wishing to enroll with an MCO must now access the application through the Provider Enrollment Wizard. Register for a BlueAccess account The KanCare health plans must pay at least 100 percent of the current fee-for-service Medicaid rate (as of 11/9/12) to all contracted, in-plan providers. Individual and family plans If you live in Kansas and are not eligible for coverage through an employer, Medicare or Medicaid these medical and dental plans are for you. Provider Login Not Registered for the Provider Portal? Please refer to your policy for specific benefits. You can negotiate a different reimbursement structure if you would like to do so. rights reserved.An Independent Licensee of the Blue Cross and Blue Shield Association. Itemized Bill Submission Form. Non-Discrimination Statement and Foreign Language Access. State of Kansas. injection,infusions,prophylactic,therapeutic,diagnostic,86365,96366,96367,96368,96369,96370,96371,96372,96373,96374,96375,96376,96377,96379,A4211,G0260,G0429,D9610,D9612, time,therapeutic,therapy,modalities,97032,97034,97035,97036,97039,97110,97112,97113,97116,97124,97139,97140,97150,97530,97532,97535,97537,97542,G0237,G0238,S5100,S5110,S5115,S5125,S5130,S5135,S8950,S9482, trigger,injection,corticosteroid,myofascial,20552,20553, tumor,field,treatment,glioblastoma,temozolomide,77299,E0766,A4555,C71.0,C71.1,C71.2,C71.3,C71.4,C81.5,C71.6,C71.7,C71.8,C71.9,malignant,neoplasm, Vasopneumatic, Device, Therapy, Lymphadema, 97016,97139,97140,97150,97530,97532,97535,97537,97542,G0237,G02389, weight,stress,exercise,S9449,S9454,S9451,management,class, 2023 CPT Evaluation and Management Guidelines, IOP, PHP, and Inpatient Treatment Services for Substance Abuse and Psychiatric Care, Electroencephalogram (EEG) Video Monitoring, Excision and Biopsy of Benign and Malignant Lesions, Gastrointestinal Endoscopies and Related Services, Health Behavior Assessment and Intervention, Increased Procedural Service (Modifier 22), National Correct Coding Initiative (NCCI), Newborn and Neonatal Critical and Intensive Care Services, Physician Fee Schedule Status Indicator Policy, Risk Adjustment and Acute Inpatient Diagnosis, Serious Adverse Events, formerly Never Events, Therapeutic, Prophylactic, and Diagnostic Injections and Infusions, Weight Management, Stress Management, and Exercise Classes, Other professional organizations and societies. Communications issued by Capital Blue Cross in its capacity as administrator of programs and provider relations for all companies. We offer deep discounts and one of the largest dental networks in the nation, along with ways to customize our plans for total flexibility. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All The information in My Health Toolkit can help you understand your health plan benefits. For confirmation of which services may be eligible for coverage and description of when medical services are considered medically necessary, not medically necessary or investigational. Applications for facilities, hospitals and HCBS providers as well as behavioral health providers are available at the Enrollment wizard page. The Blue KC Provider's Guide has been developed to support you and your staff with basic, important information about Medicare Advantage plans with Blue Cross Blue Shield of Kansas City. Contact Us | Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All Healthcare benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company, Capital Advantage Assurance Company and Keystone Health Plan Central. Please enter your credentials. Learn More Kansas dental network Search for an in-network dentist or dental specialist within Kansas. Medicare Advantage Members click here to log in or create a profile Don't have an account with us? Credentialing Status. List of all Payment and Coding Policies (A-Z). User ID: Password: Show password Credentialing Status Obtain forms for: Pre-authorization Pharmacy, Pre-service, Utilization Management, and These policies are written following industry standard recommendations from sources such as: Coverage of any service is determined by date of service, a member's eligibility and benefit . During the enrollment process, you will select which MCO(s) you wish your application and supporting documentation to be sent to for use in the MCO credentialing and contracting process. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All This resource guide is intended to provide clarification and updates to the provider enrollment requirements for Kansas Medicaid Providers. rights reserved.Healthcare benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company, Capital Advantage Assurance Company and Keystone Health Plan Central. What are Payment Policies. To ensure a broad base of providers, we encourage providers to enroll with each of the KanCare plans. Medical/Dental Claim Form ( PDF) Pharmacy Claim Form ( PDF) BlueCard Worldwide International Claim Form. Learn More National dental network You will be asked to provide your current (active) provider ID or previous (inactive) provider ID. Provider Powered by PAHub A+ A-Help Before you get started, in addition to your insurance card, you will need the following information. rights reserved.Blue Cross and Blue Shield of Kansas is an independent licensee of the Blue Cross rights reserved. 1-785-291-7000. The State Employee Health Plan (SEHP) offers four medical plans (Plans A, C, J, and N) for Active State Employees, Non State Employer Group, and NON-MEDICARE Eligible Retiree/Direct Bill Members. Claims Inquiry Form ( PDF) FEP Member Reimbursement Claim Form. The following health plans or managed care organizations (MCOs) were awarded contracts to provide KanCare services: Accessibility Policy| These policies are written following industry standard recommendations from sources such as: Coverage of any service is determined by date of service, a member's eligibility and benefit limits for the service or services rendered, all terms of the Provider Service Agreement, and other standards of coding rules and guidelines. This is the same application used to apply directly with Kansas Medicaid. This is the same application used to apply directly with Kansas Medicaid. National Provider ID (NPI): Cancel. Find drug lists, pharmacy program information, and provider resources. and Blue Shield Association. Please provide your existing KMAP ID in the appropriate box. anesthesia,epidural,sedation,PCA,01960,01961,01967,01969,01968,01996,31500,36563,36557,36558,36560,36561,36565,36566,36570,36571,36575,36576,36578,36581,36582,36583,36584,36585,36589,36590,62350,62351,62360,62361,62362,94002,94003,94004,ventilator, APN,APRN,CRNA,nurse,anesthetists,advanced,registered, Bariatrics, bariatric,B12,holotranscolbalamin,methylmalonic,screening,global,post-operative,90,vitamni,injectino,J3420,96372,43775,43770,43645,43644,43847,43842,43843,43845,43846, rehabilitation, cardiac,assessment,93797,93798,G0422.G0423,exercise,modification,heart, chiropractic,manipulation,manipulative,spinal,muskuloskeletal,extraspinal,therapeutic,98940,98941,98942,98943,98925,98926,98927,98928,98929,97110,97012, cloning,copy,paste,cut,template,default,cloned, COVID,19,Vaccine,Pfizer,Moderna,Jansen,booster,coronavirus,91300,91305,91307,91301,91306,91303,0001A,0051A,0071A,0011A,0031A,0002A,0052A,0072A,0012A,0003A,0053A,0013A,0004A,0054A,0064A,0034A,86328,86413,86769,87426,87635,U0001,U0002,U0003,U0004,U0005,guidelines,symptoms,suspected,exposure,testing,99072,S8031,99211,G2023,G2024,99000,99001,SARSCoV,CDC,AMA, CPAP,DME,equipment,sleep,apnea,hypercapnia,breathing,hypoventilation,obstructive,A4604,A7027,A7028,A7029,A7030,A7031,A7032,A7033,A7034,A7035,A7036,A7037,A7038,A7039,A7046,E0562,E0601,E1390,E0470,E0471,E0472,rented,pressure, cryosurgery,cryo,acne,warts,dermatofibroma,hemangioma,keloid,molluscum,contagiosum,myxoid,cyst,pyogenic,granuloma,sebborrheic,keratoses,skin,tags,actinic,lesion,benign, dental,dentist,pedodontists,orthodontists,peridontists,endodontists,prosthodontists,ADA,CDT. For Healthcare Providers Visit the secure portal to access a variety of Blue KC information - including medical policies, claim information and more. All providers wishing to enroll with an MCO must now access the application through the Provider Enrollment Wizard. Log in to Availity Blue Cross and Blue Shield of Kansas. This information can be obtained by contacting your prescribing physician. This guide is intended to assist you in understanding the key policies and procedures applicable to your practice or facility. We're dedicated to keeping your online personal information private and secure. rights reserved.BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue KC has developed Provider Payment Policies to provide guidance on payment methodologies as they pertain to submitted claims. rights reserved.Blue Cross and Blue Shield of Vermont is an Independent Licensee of the Blue Cross and Blue Shield Association. How to Use the Provider Portal. To provide more detail, review the Provider Enrollment Guide here. As of July 1, 2019, the KanCare MCOs started denying payments for providers who are not actively enrolled with KMAP. It does not describe all the parts of the plan or guarantee payment, reimbursement or eligibility of coverage. If you do not sign up with the KanCare health plans, you will be considered an out-of-network provider. However, while enrollment in KMAP is required, seeing Fee For Service members is not mandated. Blue Cross and Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. Provider Out of Network Form. If you have a question about your MyBlueKC account, call the phone number below and we'll connect you with the right team member. The Deductible, Coinsurance, and Out-of-Pocket (OOP) maximums differ among the plans and your medical benefits have no lifetime maximum. PROVIDER LOGIN Members Have It Made with Blue Blue KC members can access doctors, hospitals and pharmacies through a variety of networks. Privacy Statement | Blue KC has recently made changes to the following payment policies. Forgot Password? General Inquiries. All rights reserved. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All In the event of a conflict between any policies, the Member's coverage document will govern. You can find more information about each of the KanCare plans, KanCare 2.0 2018-2019 Historical Information, Reconsideration, Appeals, External Rev, Fair Hearings & Grievances, Quality Management Strategy and Encounter Audits, UnitedHealthcare Community Plan of Kansas, Aetna Better Health of Kansas (Available to members January 1, 2019). rights reserved.Blue Cross and Blue Shield of Florida, Inc. is an Independent Licensee of the Blue Cross and Blue Shield Association. 1133 SW Topeka Boulevard. Once your enrollment with KMAP is approved, the application and all supporting documentation will be sent to a portal for retrieval/download by the MCOs. The rate cannot decrease for the life of the KanCare contracts. Obtain forms for: Pre-authorization Pharmacy, Pre-service, Utilization Management, and; Little Stars Physician Referral forms; Forms Go to Payment Policies New Provider Network Interest Form. Register Now Username Password How to Use the Provider Portal Forgot Username? Blue Cross and Blue Shield of Kansas offers a variety of health and dental insurance plans for individuals, families and employers located in Kansas. Final payment is subject to the application of claims adjudication and edits common to the industry. This resource guide is intended to provide clarification and updates . For Prescription Drugs: Name of drug/medication; Strength of the drug (example 5 mg) Quantity being prescribed; Days supply . knee,orthotic,braces,injury,sprain,prefabricated,custom,osteoarthritis,L1834,L1840,L1844,L1846,L1860,L2320,L2330,L2755L2800,L2961,L1810,L1812,L1820,L1832,L1833,L1834,L1844,L1845,L1846,L1847,L1848,L1850,L1851,L1852,L1860, Maternity, Obstetrical, Antepartum, fetal, Delivery, Pregnancy, Gestation, Cesarean, Vaginal, Birth, VBAC, Postpartum, Newborn, Umbilical, 59400, 59409, 59410, 59412, 59414, 59425, 59426, 59530, 59510, 59514, 59515, 59610, 59612, 59614, 59618, 59620, 59622, 59899, 99460, 99461, 99462, 99463, 99464, 99465, 99477, 99478, 99479, 99480, MOHS, Micrographic, Carcinoma, Dermatofibrosarcoma, Melanoma, malignant, Squamous, Cell, histiocytoma, microcystic, Sebaceous, 17311, 17312, 17313, 17314, 17315, ncci,guidelines,edit,mue,addon,exclusive,extensive,standards,separate,rationale, wound, negative,ulcer,delayed,npwt,diabetic,surgical,traumatic.pressure,therapy,E2402,A6550,A7000,A7001,K0743,K0744,K0745,K0746,97605,97606, Newborn, Neonatal, NICU, Intensive, Care, Critical 99460, 99462, 99463, 99464, 99465, 99477, 99478, 99479, 99480, 99468, 99469, 31500, 36000, 36400, 36405, 36406, 36410, 36415, 36420, 36600, 36430, 36440, 36510, 36555, 36591, 36660, 43752, 43753, 51100, 51701, 51702, 71045, 71046, 62270, 92953, 93561, 93562, 94002, 94004, 94375, 94610, 94660, 94662, 94760, 94761, 94762, 94780, 949781, Office, Facility, Fees, Place, Service, Clinic, Equipment, E/M, physician,fee,schedule,indicator,medicare,status,bundled,active,excluded,valid,invalid,measurement,noncovered,restricted,statutory,exclusion,cms, review,post-service,claim,reimbursed,fraud,waste,abuse,documentation, preventive,medicine,evaluate,health,screening,99381,99382,99383,99384,99385,99386,99387,99391,99392,99393,99394,99395,99396,99397, Proton,beam,therapy,treatment,delivery,photon,77520,77522,77523,77525, oig,risk,adjustment,acute,diagnosis,resolved,outpatient,history,inspector,general,conditions, robot,robotic,surgery,s2900,surgical,procedure, SBRT,SRS,FSRT,radiotherapy,radiation,therapy,sterotactic,treatment,77470,77370,77300,77331,77293,77014,77301,77338,77371,77372,77373,77336,77401,OART,orthovoltage,evicore, bundled,indicator,status,A4262,A4263,A4300,A4550,G0269,G0501,Q3031,R0076,0573T,0538T,0539T,15850,20930,20936,22841,34839,36000,36416,38204,90885,90887,90889,92352,92353,92354,92355,92358,92371,92531,92532,92533,92534,92605,92606,92618,92921,92925,92929,92934,92938,92944,93740,93770,94005,94150,96040,96902,97010,97602,98960,98961,98962,99000,99001,99002,99024,99050,99051,99053,99056,99058,99060,99070,99072,99071,99078,99080,99100,99116,99135,99140,99288,99339,99340,99366,99367,99368,99374,99377,99379,99380,99485,99486, telehealth,interactive,video,telecommunication. Independent licensees of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All . Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All rights reserved.BlueCross BlueShield of Tennessee, Inc. is an independent licensee of the BlueCross BlueShield Association. Im already enrolled with KMAP, when should I provide my existing KMAP ID? rights reserved.A Division of Health Now New York Inc. An Independent Licensee of the BlueCross BlueShield Association. Independent licensees of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Due to the Managed Care Organization health plan regulations, enrollment with KMAP is required. Topeka, KS 66629-0001. www.bcbsks.com. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All rights reserved.An independent licensee of the Blue Cross and Blue Shield Association. Blue KC has developed Provider Payment Policies to provide guidance on payment methodologies as they pertain to submitted claims. bilateral,indicator,modifier,descriptor,reimbursement,left,right,allowable,procedure, admission,subsequent,readmission,criteria,related,hospital,related, observation,deletion,revision,hospital,office,inpatient,G0378,G0379,88221,99222,99223,99231,99232,99233,99238,99239,99234,99235,99236,99242,99243,99244,99245,99251,99252,99253,99254,99255,99202,99203,99204,99205,99212,99213,99214,99215, treatment,psychiatric,evauation,multidisciplinary,intensive,outpatient,h0015,s0201,h0035,h0018,h0010,90853,g0410,90791,90792,99484,therapy,group,inpatient,residential,psychiatrist,psycho,logist,facility,intervention, critical,illness,injury,deterioration,time,life-threatening,organ-failure,99291,99292, emergency,ED,99281,99282,99283,99284,99285,G0380,G0381,G0382,G0383,G0384, prolonged,99354,99355,99356,99357,99358,99359,99417. Sitemap | Blue Cross and Blue Shield of Kansas . Check the initial credentialing status for new providers. rights reserved.Blue Cross Blue Shield of Nebraska is an independent licensee of the Blue Cross Blue Shield Association. (888) 989-8842. Planning,advanced,directive,will,99497,99498,proxy,attorney, Advanced,Nurse,Midwives,asistants,anesthesia,CRNA,APRN,PA, allergy,allergic,reaction,immunotherapy,95004,95012,95017,95018,95024,95027,95028,95044,95052,95056,95060,95065,95071,95076,95079, glucose,blood,sugar,CGM,95249,95250,95251,sensor,diabetes,99091,monitoring. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All Out-of-network providers will receive 90 percent of the current fee-for-service rates. Check the initial credentialing status for new providers. An independent licensee of the Blue Cross and Blue Shield Associationdocument.write(new Date().getFullYear()) Blue Cross and Blue Shield of Kansas City. rights reserved.Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Records Request We're here to help answer all your questions Monday - Friday, 8 a.m. - 8 p.m. Central. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All rights reserved.Excellus BlueCross BlueShield, a nonprofit Independent Licensee of the BlueCross BlueShield Association. Access Professional Provider resources Medicare Advantage Provider Access Medicare Advantage resources COVID-19 Provider Information Access COVID-19 resources Need access to Availity? durable,equipment,DME,supplies,HCPCS,rental, Echo,sonogram,heart,doppler,ultrasound,transthoracic,-,transesophageal,transcatheter,93303,93304,93306,93307,93308,93312,93313,93314,93315,93316,93317,93318,93320,93321,93325,93350,93351,93352,93355,A9700,C1759,C8921,C9822,C8923,C8924,C8925,C8926,C8927,C8928,C8929,C8930, electroencephalogram, eeg,diagnostic,epilepsy,seizures,data,monitoring,veeg,video,intractable,anticonvulsant, lesions,benign,malignant,excision,skin,margins,11600,11601,11602,11603,11604,11606,11620,11621,11622,11623,11624,11626,11640,11641,11642,11644,11646,11400,11401,11402,11043,11404,11406,11420,11421,11422,11423,11424,11426,11440,11441,11442,11443,11444,11446,11450,11451,1462,11463,11470,11471, extracorporeal,oxygenation,membrane,ECMO,ECLS,33946,33947,33948,33949,33951,33952,33953,33954,33955,33956,33957,33958,33959,33962,33963,33964,33965,33966,33969,33984,33985,33986,33987,33988,33989, facility,supplies,equipment,materials,supplements,remedies, gastrointestinal,endoscopy,colonoscopy,screening,colorectal,polyp,preventive,biopsy,diagnostic,45378,45380,43232,43202,43216,43217,45385,polyp,flexible,tumor,mass,lesion, surgery,global,pre-operative,post-operative,-54,-55,-56,-57,99024,surgical, behavior,assessment,intervention,96156,96158,96159,96164,96165,96167,96168,96170,96171, hemodialysis,renal,end,stage,esrd,dialyzing,cycle,90935,90937,90951,90952,90953,90954,90955,90956,90957,90958,90959,90960,90961,90962,90967,90968,90969,90970,90999,professional,facility,urea,reduction,ratio,frequency,cg,kx,g1,g2.g3,g4,g5,g6,kx, hypoglossal,apnea,sleep,obstructive,0466T,64568,61886,61888,64569,64570,0467T,0468T,95970,95976,95977, manifestation,diagnosis,icd10,underlying,disease,primary,disease,principle, immunization,vaccine,component, antigen,conjugates,adjuvants,90460,90461,99071,90472,9473,90474,toxoid, Implants, Inpatient, Facility, inserted, material, tissue, implantable, durable, medical, equipment, modifier,22,increased,greater,difficult,additional,effort, jw,modifier,drug,waste,wastage,vial,single,biological,discarded,dosage,administered,unused,dose.
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