Transcription
Kansas Fall 2019CommunityConnectionsFor More InformationCall our Provider Services Center at 877-542-9235Visit UHCprovider.com
Important information for health care professionals and facilitiesIn This Issue Prior Authorization Required for All Non-Participating Providers 2020 Value-Added Benefits: New Year, More Benefits Dual Special Needs Plan Expands Coverage Areas Maternity Support for UnitedHealthcare Community Plan Members Change to Protected Income Level Care Provider Enrollment Managed Care RegulationImplementation Update Cultural Competency and the American with Disabilities Act TrainingCommunity Connections: KS – Fall 2019p.1Provider Services Center: 877-542-9235
Important information for health care professionals and facilities Happy and Healthy at Home: Members who movefrom a nursing facility to an independent living settingcan receive a 1,000 debit card to purchase wellnessitems. They can receive 50 per month for everymonth they’re not in a nursing-type facility. Prenatal Debit Card Reward: Members get a 200debit card reward for getting a first prenatal visit infirst trimester (42 days after enrollment). And careproviders can earn 60 by completing the ObstetricsRisk Assessment Form (OBRAF), available underforms at UHCprovider.com.Prior Authorization Required for AllNon-Participating ProvidersEffective with dates of service on or after Oct. 1, 2019,all non-emergency services provided by care providerswho are not part of the UnitedHealthcare CommunityCare network must obtain prior authorization for claimsto be paid.2020 Value-Added Benefits:New Year, More BenefitsWe’re focused on listening to the needs of our members.With that in mind, we’re excited to share a few of our2020 value-added benefits. Our goal is to help membersget the care they need and make it a little easier. We’refocused on offering these extra benefits to improve healthand support everyday life. More Rides: Up to 12 rides annually, including thegrocery store, food banks, pharmacy, church, bank,prenatal classes and job-related activities.We offer our members over 35 extra services. Afull list of value-added benefits is available atUHCprovider.com/KScommunityplan.Dual Special Needs Plan ExpandsCoverage AreasOn Jan. 1, 2020, UnitedHealthcare Community Plan willbegin serving more eligible members in Kansas with itsDual Special Needs Plan (DSNP) – United HealthcareDual Complete , a Medicare Advantage plan. The planwill expand to the following Kansas counties for 2020: Atchison Bourbon Cherokee Crawford LabetteIn addition to these new counties for 2020, the DualComplete Plan will continue to serve people in Butler,Cowley, Douglas, Franklin, Harvey, Jackson, Jefferson,Johnson, Leavenworth, Miami, Osage, Sedgwick, Sumnerand Wyandotte counties. Adult Dental: Any members over age 21 can visita participating dental provider for exams, x-rays,cleanings and fillings. Benefit covers up to 500per year.(continued on next page)33CommunityConnections:KS –2013Fall 2019Practice Matters:TX - SummerProvider ServicesCustomerService Center: 877-542-9235888-362-3368
Important information for health care professionals and facilities(continued on previous page)Visit UHCprovider.com/KSDSNP for additionalinformation on the Dual Complete Plan or checkout the 2020 Dual Complete educational serieson the Kansas channel of UHC On Air on Link.Go to UHCprovider.com and click on the Linkbutton in the top right corner. Then choose theUHC On Air tile from your Link dashboard.Maternity Support forUnitedHealthcare CommunityPlan MembersOur maternity programs provide UnitedHealthcareCommunity Plan members with education, resourcesand individualized support to help them focus on ahealthy pregnancy and birth. These programs areavailable to members at no extra cost. Incentives may beavailable for care providers and members who participatein the programs.Visit UHCprovider.com/maternity to learn more.Change to Protected Income LevelThe state announced allocated funding for a protectedincome level increase to 1,177 a month. This changetook effect Sept. 1, 2019, with the increase changing from 747 per month to 1,177 per month.This change has a significant impact on individuals whoreceive services to allow them to stay in their own homesrather than live in a nursing facility or institution and itdirectly impacts Kansans’ quality of life.Care Provider EnrollmentManaged Care RegulationImplementation UpdateAll KanCare managed care organization (MCO) networkcare providers who receive payment for KanCaremembers are required to be screened and enrolledin the Kansas Medical Assistance Program (KMAP).Care providers must be sure they have enrolled withKMAP and have an active KMAP ID. Failure to do sowill result in claims denials as of July 1, 2019. Moreinformation is available at sp and searching for KMAPBulletin #19040.Synchronization and use of the following data elementsacross the MCOs and KMAP is critical to accurateclaims processing: NPI Care provider name Provider types and specialties/services Taxonomy Tax ID numberTo enroll with KMAP, access the ProviderEnrollment Wizard at EnrollmentCreate.More information is available at sp andsearching for KMAP Bulletin #18261.All care providers should direct any changes to theirprovider record to KMAP, the central point of contact forthese updates. Once the updates are received, KMAPwill forward the requested updates to the MCOs, whichwill then update their records accordingly.(continued on next page)44CommunityConnections:KS –2013Fall 2019Practice Matters:TX - SummerProvider ServicesCustomerService Center: 877-542-9235888-362-3368
Important information for health care professionals and facilities(continued on previous page)Care providers can call KMAP at 800-933-6593 with anyadditional questions on their status with KMAP. Theyalso can contact their Home and Community-BasedServices Provider Advocate on their MCO status. A mapof advocates is available at .pdf.Effective with the July 1, 2019 requirements, allphysicians and other eligible practitioners who areordering, referring, attending, prescribing orsponsoring (ORAPS) items or services to KansasMedicaid beneficiaries (or other professionals whoprovide services under the state plan) are required toenroll with KMAP and have an active KMAP ID. Claimswill deny if the ORAPS provider is not enrolled withKMAP with a valid NPI.More information is available at sp andsearching for General Bulletin #18180, #18183,#18218, #18223 and #18131. You can alsosearch for KMAP Bulletin #19041.Cultural Competency and theAmerican with DisabilitiesAct TrainingThis training is available through UHC OnAir. For cultural competency resources, alth-safety/cultural-competency.html.Once the care provider completes the training video and/or receives cultural competency training elsewhere, theyare encouraged to change their status to “yes” on theprovider portal.Care provider cultural competency is defined as the abilityof providers to effectively deliver health care services thatmeet the social, cultural, and linguistic needs of patients.This training discusses why cultural competency and theAmericans with Disabilities Act (ADA) requirements areimportant to care providers, including information on: Cultural competency overview and the impact ofthese requirements on care providers ADA overview Provider’s role in complying with these requirements55CommunityConnections:KS –2013Fall 2019Practice Matters:TX - SummerProvider ServicesCustomerService Center: 877-542-9235888-362-3368
KansasCommunityConnectionsCommunity Connections is a quartly publication for physicians and otherhealth care professionals and facilities in the UnitedHealthcare network.Community PlanDoc#: PCA-1-19-00636-C&S-PM 11082019CPT is a registered trademark of the American Medical Association. 2019 UnitedHealth Group, Inc. All Rights Reserved.10895 GrandviewSuite 200Overland Park, KS 66210
in the Kansas Medical Assistance Program (KMAP). Care providers must be sure they have enrolled with KMAP and have an active KMAP ID. Failure to do so will result in claims denials as of July 1, 2019. More information is available at kmap-state-ks.us/Public/ bulletins/bul
