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Corrected Claim Form
EFT Form
Third Party Liability (TPL) Form
Provider Update Form/ Practice Change Form
PCP Change Form

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Frequently Asked Questions

Home > Provider Home Page > KS Provider Resources

Provider Resources - Kansas   ( Forms are in Adobe Acrobat Reader.)

Click here for Pharmacy Resources
Announcements:  

05-12-10: IMPORTANT NOTICE TO ALL KANSAS PROVIDERS REGARDING PROVIDER PAYMENT RATES

04-28-10: Important Announcement Regarding Provider Rates

04-20-10: SCHEDULED MAINTENANCE: The CMFHP website will be down for maintenance beginning April 23rd at 3:00. It is scheduled to be operational beginning Monday morning April 26th by 8:00.
04-12-10: Providers can now submit "real-time" claims - see the online training manual (right sidebar) for more info.
03-08-10: New Prior Auth Quick Guide available
03-26-10: IMPORTANT NOTICE FROM CHILDREN’S MERCY FAMILY HEALTH PARTNERS (CMFHP) TO ALL KANSAS PROVIDERS REGARDING PROVIDER PAYMENT RATES
03-26-10: CMFHP Donates $50,000 to KHPA to Assist with Medicaid Application Backlog

03-08-10: New Care Management Quick Guide available


H1N1 - KS providers    KS VAERS information

additional H1N1 links:
www.flu.gov    www.cdc.gov/H1N1flu/


Claims Address Children's Mercy Family Health Partners
P.O. Box 411806, Kansas City, MO 64141-1806
Electronic Payer ID Emdeon: 31472
Gateway EDI: 31472
SSI: 31472
ASK / EDI Midwest: 31472
Companion Guide KS 837P         PDF      Word

Companion Guide KS 837I        PDF      Word

Medical Review Process

Medical review is conducted to confirm the medical necessity of treatments or services rendered, as well as the appropriateness of the care setting. Medical review requires evaluation of specific clinical information on-site, over the telephone, or via written communication. Medical Review Nurses compile all pertinent clinical information gathered from the treating practitioners/staff, review against the medical necessity decision criteria and consider individual patient needs. Once complete, the Medical Review Nurse confirms medical necessity, the appropriateness of the care setting, and authorizes the requested service. When the Medical Review Nurse is not able to confirm the medical necessity and appropriateness of care setting, the case is referred to a physician. The Medical Director makes the final decision.

Children’s Mercy Family Health Partners does not provide financial or other types of incentives to practitioners, employees, or other individuals that encourage decisions that result in underutilization.

If you would like to discuss a decision with Children’s Mercy Family Health Partners’ Medical Director, you may call the Prior Authorization Department at 1-888-691-4874 and ask to speak with the Medical Director.

Providers and/or members have the right to a copy of the criteria used in making decisions about requests. If you would like a copy of the criteria, please contact the Prior Authorization Department at 1-888-691-4874 or fax your request to 1-877-9366. Children’s Mercy Family Health Partners will mail or fax you a written copy of the criteria within three (3) business days of your request.

MO PHONE – 1-888-691-4872
KS PHONE - 1-888-691-4874
Forms Claim Adjustment Form/
Corrected Claim Form 		To request a correction or adjustment to a claim
  Beneficiary Bank Info For EFT
  Prior Authorization Form For services requiring a pre-auth
  Abortion Consent Form  
  Hysterectomy Consent Form  
  Pregnancy Risk Screening Form 
  Sterilization Consent Form  
  PCP Change Form
  Practice Change Form For providers who need to update address, contact information, NPI, personnel, etc.
Resources Provider Administration Manual  
Prior Authorization Quick Guide
Case Management Quick Guide
Companion Guide KS 837P         PDF      Word
Companion Guide KS 837I        PDF      Word
  Pharmacy Resources CMFHP Specialty Drug List and Approval Process, Medication Exception Request, PA fax forms and more
2010 Preferred Drug List
UM Plan
Other Helpful
Information		 Asthma Management Program CMFHP's comprehensive asthma health improvement program is available to eligible provider offices. CMFHP's Asthma Management Program earned the Leadership award from the U.S. Environmental Protection Agency.
  HeLP Program CMFHP's Healthy Lifestyles Program (HeLP) focuses on childhood obesity and related co-morbidities. This health improvement program is available to eligible provider offices.
  Lead Posioning Prevention Care Management CMFHP's Lead Posioning Prevention Care Management health improvement program is available for members with elevated blood lead levels. The care management program includes education and coordination of services and resources.
  Special Health Care Needs CMFHP Special Health Care Needs (SHCN) Outreach Coordinators work with Kansas Special Health Services Program (SHS) program staff to assist in providing care for members that are enrolled in the program.
  CMFHP Eligibility Information for patients interested in becoming members of Children's Mercy Family Health Partners.
Child Health Library Child health information from Children's Mercy Hospitals and Clinics: Care Cards, Well Child Cards, Healthy Kids University classes, podcasts, video and much more.
KHPA Kansas Health Policy Authority
KMAP Kansas Medical Assistance Program
Kansas HealthWave SCHIP/Medicaid Program for the state of Kansas
CMS Centers for Medicare and Medicaid Services
  Minority Vendors Minority Vendors - Children's Mercy Family Health Partners is interested in doing business with you. For more information please click on the following links: