Providers can appeal the adjudication of a claim or an action taken on a claim. For fee-for-service claims, reference Section 5300 of the General Billing Fee-for-Service Provider Manual on the Provider Manuals page of the KMAP website.
For KanCare claims filed with a managed care organization (MCO), the appropriate actions must be taken according to each individual plan.
Reference the following links for the appropriate resources:
- Amerigroup: Reference the Kansas Provider Manual under Manuals & Referral Directories of the Provider Resources and Documents heading
- Sunflower: Claim Dispute/Appeal Process
- UnitedHealthcare: KanCare Provider Administrative Guides
