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Reminder of Required Provider Actions

Date: 07/24/24

A Message for All Providers. Please share with your team.

Reminders of actions providers are contractually obligated to complete.

Sunflower Health Plan is committed to making it easier for providers to work with us. We've developed a checklist to help you ensure you are meeting the required obligations.

Medicaid, Ambetter and Wellcare Providers - QUARTERLY PaySpan Review

  • PaySpan EFT review - Login to your PaySpan account, click on 'Payees', complete a search on your Tax Identification Number. Any records that are not 'registered' are not set up to receive EFT payments.
  • PaySpan Remittance Advice - Login to your PaySpan account, click on ‘Your Payments’, Click the ‘Payment Count’ link in the center of the page, click on 'view' next to the payment and your remit will display in a separate browser window.
  • See the PaySpan FAQ document (PDF) for additional support.

Ambetter & Wellcare Providers - QUARTERLY

Roster Updates - Have you sent a roster to the health plan this quarter? Download our preferred roster template and send your update to our Provider Network Operations team.

Medicaid, Ambetter and Wellcare Providers - ANNUAL

  • Cultural Competency Training – Have you completed Cultural Competency training this year? Complete and confirm you have completed the training. We'll send you a certificate of completion.
  • Find a Doctor – Review our Find A Doctor page to ensure your company and/or practitioner information is accurate. See our Provider/Practitioner Changes page if you need to make changes.
  • CAQH Review - Have you replaced expired CAQH documents this year? Visit the CAQH site.

Medicaid Providers

  • KMAP Revalidation - Have you revalidated your KMAP enrollment within the last 2-3 years? Visit the KMAP Provider Enrollment Portal to revalidate your provider details.
  • Languages and Accessibility - Update your KMAP enrollment to include languages spoken in your practice as well as your accessibility for members. Visit the KMAP Provider Enrollment Portal to update your provider details.

Medicaid HCBS & FMS Providers - ANNUAL

Annual Audit - Are you staying up to date with your employee background checks? Visit KMAP General Bulletin 23017 to see more information.

Wellcare Providers - ANNUAL

  • Model of Care – Have you completed Model of Care training this year? Complete and confirm you have completed the training.
  • Fraud, Waste & Abuse (FWA) - Have you completed FWA training this year?
  • Medicare Provider Compliance - Have you reviewed the Medicare Provider Compliance Tips this year? Review the tips related to the services you provide.

Medicaid Providers - Please be aware, KDHE requires our Provider Relations team to reach out to you, at minimum, twice a year. Please make time to return their phone calls.

If you have questions about this bulletin or other provider resources, please contact your Provider Relations Representative call us at the numbers below.