KMAP BULLETIN: Enrollment Types, NPI Requirements, and MCO Contracting Request Form Notifications
Date: 05/18/20
KMAP GENERAL BULLETIN 20098 (PDF)
Effective January 1, 2018, in order to contract with a Managed Care Organization (MCO) or to receive reimbursement for Medicaid eligible services, a provider must be actively enrolled in the Kansas Medical Assistance Program (KMAP). The enrollment process should begin with the KMAP Provider Enrollment Wizard where a provider will be required to identify the type of entity for which they are requesting enrollment.
The enrollment types are intended to categorize providers who have the same or similar requirements (attachments, disclosures, NPI type etc.). The enrollment type also dictates a provider's ability to bill claims to the MCOs or KMAP.
Individual within a Group Organizational Type Code and W-9
For an Individual within a Group (IG), it is important to note that the group must be enrolled and have a KMMS identification (ID) number before an IG can be enrolled and affiliated as an IG within that group. During the enrollment, the IG will be required to list the KMMS ID for all group service locations where he/she will see Kansas Medicaid beneficiaries. Please note a W-9 for EACH unique (different Tax IDs) group affiliation is required. During the enrollment, the IG should choose “Individual” as the “Organizational Type” Code. After the initial application for the IG is submitted, any new group affiliations must be handled through a maintenance request with KMAP and a W-9 for each unique (different Tax IDs) affiliation is required.
MCO Contracting Request Form Notifications
For providers already enrolled with KMAP and wishing to start the enrollment process with one or more of the MCOs, they will complete the MCO Contracting Request form in the Provider Enrollment Wizard.
Upon submitting the MCO Contracting Request Form, the provider will receive two emails. One email contains an Application Tracking Number (ATN). The second email containing a system generated password. The provider will use the ATN and password supplied to resume and submit the MCO Contracting Request Form. Please check your spam folder if you have not received the ATN and password email from Kansas-Provider-Enrollment@dxc.com. If you have questions, contact Provider Enrollment at 1-800-933-6593.
Reminder - Accuracy and Completeness
In order to eliminate the potential for the return of an improperly completed application, providers are encouraged to validate the accuracy and completeness of all information submitted on an application. Any application received that does not comply (example- Individual application is submitted with a Type 2 NPI) with the requirements in the chart below will be returned to provider. The application will not be processed until the appropriate corrections, as requested in the return notification comments, are completed and the application is resubmitted.
Enrollment Type Reference Chart
The following grid should be referenced when determining which Enrollment Type to select. Please note that not all Enrollment Types are available for all Provider Types. For example, a hospital may only enroll as a Facility where a physician may enroll as an Individual, Individual within a Group or an OPR. For information regarding CMS NPI requirements, the CMS NPI Fact Sheet can be found here.