Institutional Provider Tools and Resources
Body
Manuals
- Institutional Provider Manual (offsite link)
- See the Institutional Provider Manual for information on Revenue Codes and Items Not Separately Billable
- Electronic Inpatient Precertification System Manual
- Establishing Secure Access for Providers to Member Information
- Quality-Based Reimbursement Program (QBRP) Portal Manual
- Claims Pricing Manual
Resources
- 2024 State of Kansas Comprehensive Site of Care Specialty Drug Program Prescription Drug List (Excel workbook)
- 2023 New Directions Medical Necessity Criteria (offsite link)
- Preventive Services Quick Reference Guide
- Remittance Advice - HIPAA Codes (offsite link)
- Diagnosis Codes Exempt from POA Reporting (offsite link)
- 2023 State of Kansas Pharmacy Benefit List
- Exchange, BlueCard and Kansas Provider Networks
- Policies and Procedures (offsite link)
- Outpatient Medical Drug Exclusion List
- No Surprises Act Fact Sheet
- HL7 v2 Specification (Excel document - Updated July 2022)
- Updating Provider Profile Information