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On April 22, 2024, UnitedHealth Group issued a press release, providing an update on the Change Healthcare cybersecurity incident that occurred on Feb. 21, 2024. Given the size of the data impacted, the investigation to determine whose data is impacted is expected to take several months. UnitedHealth Group believes this situation will impact “a substantial proportion of people in America” and is offering immediate credit monitoring and identity protection services, as well as a dedicated contact center to address questions. Visit Change Healthcare Cyberattack Support and/or reach out to the contact center at 1-866-262-5342 regarding any questions.

Sunflower Medicaid Provider Manual Revised

Date: 03/08/24

Revision Now Available

The Sunflower KanCare provider manual has been updated and is now available in the Provider Resources of the Sunflower website.

The manual changes include the following:

Provider Manual SectionWhat Was Updated?Page Number
Radiology & Diagnostic Imaging ServicesNational Imaging Associates is now known as EvolentMultiple Pages
Benefit Explanation and Limitations – Durable Medical EquipmentAdded clarity on non-covered DME services.Page 29
Benefit Explanation and Limitations – HCBSChanged age range from 16-64 to 0-64Page 32
Value-Added Services for Members – My Health Pays Program
  • Removal of the $75 per member cap.
  • Addition of reward for participation on the Member Advisory Committee.
  • Page 37
  • Page 38
Value-Added Services for Members – Smart Start for Your BabyRemoved 17 alpha-hydroxprogesterone caproate (17-P) referencePage 38
Value-Added Services for Members – SafeLink PhoneAddition of SafeLink Phone servicesPage 38
Value-Added Services for Members on Waivers and Other Special GroupsBrain Injury waiver members added to the Transportation to Community & Social EventsPage 40
Billing and Claims Submission - Paper Claims Submission TableReplaced paper claim address with member claim address, fax number and email addressPage 61
Grievance and Appeal Process - External Independent Third-Party Review – OptionalAdded statement related to Sunflower reversing their decision upon receipt of the EITPR requestPage 75
Grievance and Appeal Process – Pharmacy Benefit ManagerCVS details replaced with Express Scripts informationPage 76, 78
Quality Improvement Program
  • Methods for retrieval of medical records
  • How to Improve HEDIS Scores
  • Addition of the Quality Engagement Team
  • Page 82
  • Page 82
  • Page 84
Appendix VII: Claim Form Instructions - Billing Guide for a CMS-1500 and CMS UB-04Addition of when a CMS-1500 should be usedPage 93
Appendix X: Billing Tips and Reminders - Nursing Facility (NF/ICF/Bed Hold)Added revenue code 101 & 110Page 123

Thank you for your partnership with Sunflower Health Plan. If you have questions about this bulletin or other provider resources, please contact your provider network specialist or call Customer Service at 1-877-644-4623.