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Specialist Term

KanCare Provider Enrollment and Changes: Providers must use the Kansas Modular Medicaid System (KMMS) Provider Enrollment Wizard to update their information for any or all of the Medicaid fee-for-service (FFS) and managed-care organization (MCOs) health plans.

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Ambetter or Medicare Specialist Term

Please use the form below to terminate a specialist from Sunflower's Ambetter or Medicare networks.

Programs to Term (choose all that apply): required *

Specialist Name

Practitioner will be termed from all locations associated with this TIN.

Service Location Address

Term Reason required *

Update Requested By:

Move Members To (choose one): required *