Resources overview

We are committed to supporting you with the necessary resources to facilitate providing quality care and services to the members in our health plan.

Attention Kansas Providers: Availity tools and services will be available for use beginning December 15th, 2024. Please contact our Provider Services team for more information.

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Provider resources

Utilize our selection of resources to access frequently used forms, reference materials, provider manuals and guides, prior authorization information, clinical practice policies, and other support for delivering benefits to our members.

Forms 

From office administration to patient care — our Forms page offers quick access to the documents you use the most.

Training Academy

The Training Academy offers webinars, CME courses, orientations, tutorials, and more to support providers in continuing their education.

Policies, guidelines, and manuals

Our provider manuals and guides provide key information and support for delivering benefits to our members. 

Prior authorizations

Check which services require prior authorization using the Prior Authorization Lookup Tool and submit requests through Availity, fax, or phone.

Learn about Availity

Availity simplifies provider transactions such as prior authorization requests, electronic data exchange, claim submission and status, and member benefit and eligibility inquiries.

 

Medical policies and clinical guidelines

Medical Policies and Clinical Utilization Management (UM) Guidelines help us determine if a procedure is medically necessary.

Medical Policies and Clinical UM Guidelines - Coming soon

Explore more provider resources

Referrals 

 

The Healthcare Effectiveness Data and Information Set (HEDIS®) 

 

Patient360 

 

Medical management model 

 

Quality management 

 

KanCare provider resources 

 

 

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Interested in becoming a provider in the Healthy Blue network?

We look forward to working with you to provide quality service for our members.

 

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