Welcome to Sunflower Health Plan. We thank you for being part of our network of participating physicians, hospitals and other healthcare professionals.
Note: When registering/attesting, you must use a valid email address and the TIN should be entered in ######### format (no dashes please).
We Welcome Your Feedback
We strive to give our providers excellent service. Please share your feedback on the Sunflower provider-training experience to help us meet that goal.
NOTE: The July 12 Office Hours session will be cancelled in favor of the All MCO session at 12:30pm.
Join us for Office Hours where you can get your questions answered. We will have recurring, monthly 30-minute sessions for the following provider types, but any provider is welcome to attend.
Access all sessions through the Office Hours Zoom link. Each session will be opened at 12:30 p.m. on the following schedule:
- HCBS/LTSS Providers - second Tuesday of each month
- DME Providers - second Wednesday of each month
- Hospice Providers - second Thursday of each month
- Primary Care Providers - third Tuesday of each month
- Hospital Providers - third Wednesday of each month
- FQHC/RHC/IHC Providers - third Thursday of each month
- Behavioral Health Providers - fourth Tuesday of each month
Registration is not required for these sessions. Click the link below at 12:30 on the day of the Office Hours you wish to attend.
Training at your fingertips! Access webinars anytime, anywhere. On-demand sessions available:
All Sunflower network providers are required to complete cultural competency training, per the Centers for Medicare and Medicaid Services (CMS).
Ambetter New Provider Orientation - All new Ambetter network providers are required to complete Ambetter New Provider Orientation training.
- Please review the recorded Ambetter New Provider Orientation training presentation (with sound on).
- Or view the Ambetter New Provider Orientation (PDF)
- Then, complete the attestation form to verify the training was completed.
Sunflower KanCare/Medicaid New Provider Orientation - All new Medicaid network providers are required to complete the Sunflower Medicaid New Provider Orientation training.
- Please review the recorded Medicaid New Provider Orientation training presentation (with sound on).
- Or review the Medicaid New Provider Orientation training presentation (PDF).
- Then, complete the attestation form to verify the training was completed.
Wellcare By Allwell (Medicare) Training Resources - Visit this page for the Medicare orientation, model of care training and more.
Recredentialing Overview - This training presentation video outlines the process for recredentialing for all providers. Please be sure to turn the sound on.
Questions and Answers from Recredentialing Webinar
Q: Is there a different process for physical health providers vs. LTSS vs. SNF vs. DME providers? I would expect they would need to provide different documents, but the general process would be the same.
A: We divide our initial and recredentialing into practitioners (the people providing care) and providers/facilities (the places providing care). For practitioners, we rely on the practitioner’s profile in CAQH for the application and other non-primary source verification required documents, but for providers/facilities, the majority of the required documentation is requested directly from the facility.
Q: Do providers need to sign into a portal to upload their documents? I have a provider asking questions about what screens they are to use in CAQH.
A: CAQH is used for practitioners for initial and recredentialing but not providers/facilities. Best practice for practitioners is to log into CAQH once every 60-90 days to review and/or update any information and to replace expired documents (i.e., malpractice insurance coverage, etc.) and to re-attest that the information in their profile is true and correct.
Q: For Kansas, do providers need to return documents to you, or do we pull everything from CAQH & One Health Port? Do Disclosure of Ownerships (DOO) get sent to the state or to the health plan?
A: Washington is the only state using One Health Port. The rest are using the services of CAQH. We pull a good portion of the information needed directly from those two sources (CAQH and One Health Port), if available. Documentation that must come from a primary source (license, board certification, etc.) is pulled from those individual websites. The disclosure of ownership forms should be sent to our designated recredentialing email: firstname.lastname@example.org. DOOs for groups are stored and reused for other practitioners enrolled under the same TIN. They are considered current for one year, based on the signature date.
Q: Is there an attestation the providers must complete?
A: We use the standard attestation and release of information available in CAQH.
Q: If we receive nothing, all is well?
A: I would not always assume that no news is good news. Send any questions about a particular practitioner to email@example.com.
Q: Is there anywhere where we can verify that our providers are credentialed?
A: There is no self-help tool. You can email firstname.lastname@example.org if you have questions about the credentialing for a particular NPI.
Q: Why can't the notices be sent to the mailing address listed in CAQH? We are a CMHC and utilize space in health depts. The notices do not always get to me timely, if at all.
A: Practitioners can send a request to email@example.com to add a “credentialing/correspondence address.” The recredential notifications will continue going to the primary address locations, but will also be mailed to the credentialing/correspondence address.
Q: Providers previously in network and adding to new practice completed changes in KMAP. Do we need to also send something to Sunflower?
A: When the practitioner update is made with the state, the health plan will be sent the update. You’ll be notified if there is any additional information needed.
Q: Do you require recredentialing on facilities as well? Or just at the provider level?
A: Facilities do also have a three-year credentialing cycle.
Q: If we don't receive the letters, where do we check for all NPIs that are due for recredential?
A: You can email firstname.lastname@example.org if you have questions about the credentialing for a particular NPI.
Pre-Auth Check Tool and NIA Portal for Advanced Imaging Feb 2023 - Presentation about using the NIA portal and pre-auth check tool.
Sunflower is pleased to offer additional information of interest to our providers.
- National Nursing Home Quality Improvement Campaign
- The American Psychiatric Association Practice Guideline on the Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia (2016)
- American Geriatrics Society (AGS) - A Guide To The Management of Psychotic Disorders and Neuropsychiatric Symptoms of Dementia in Older Adults (PDF)
- Improving Dementia Care in Nursing Homes: Best Care Practices (2013 CMS Video on YouTube)
- Nursing Home Initiative on Behavioral Health and Antipsychotic Medication Reduction (2012 CMS Video on YouTube)
Kansas Opioid Products for Pain Management Prior Authorization
- Kansas Opioid PA Policy Training Presentation (PDF)
- Kansas Opioid PA Policy Training Webinar Recording - from May 22, 2018
- Turn the Tide Rx Prescribing Opioids for Pain (PDF)
- CDC Guideline for Prescribing Opioids for Chronic Pain (PDF)
- AMDG Summary of 2015 Interagency Guideline on Prescribing Opioids for Pain (PDF)
- CDC Checklist for Prescribing Opioids for Chronic Pain (PDF)
- Opioid Risk Tool (PDF)
- CRAFFT Adolescents Tool (PDF)
- CAGE Tool
- NIDA Drug Use Screening Tool
- STOP BANG Tool
- Patient Health Questionnaire (PDF)
- Clinical Opiate Withdrawal Scale Tool (PDF)
Miscellaneous Prescriber Resources
- K-TRACS Kansas Prescription Drug Monitoring Program
- COPE (Collaborative Opioid Prescribing Education) CME course
Initiation and Engagement, Follow-Up After Emergency Department or High Intensity Care for Substance Use Disorders: Optimizing the IET, FUA and FUI HEDIS® Measures - To support our providers, Sunflower now has on-demand training for the Initiation and Engagement of Substance Use Disorder Treatment (IET), Follow-Up After ED Visit for Substance Use (FUA) and Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) HEDIS Measures. This brief training will assist providers in recognizing the intent of the IET, FUA and FUI measures and share strategies that will help impact quality care and outcomes for our members. This 10-minute training is available on demand and can be taken at your convenience.
Experience of Care and Health Outcomes (ECHO) Survey Training (PDF) - The purpose of the training is to provide awareness and strategies.
We are pleased to offer training to caregivers, members, and anyone interested in foster care through live, online and interactive learning.
Caregiver Trainings include:
- Trauma Informed Care
- Youth Suicide Prevention
- Behavior Management
- Childhood Development
- CDC’s main HPV information page
- CDC video: You Are the Key to HPV Cancer Prevention (CE may be available, please check.)
- CDC HPV promotional print material
- Kansas Chapter, American Academy of Pediatrics HPV vaccine webinar
- Video: Adverse Incident Reporting “AIR” System Training - from KDADS
- Meningococcal Vaccine Toolkit - from Immunize Kansas Coalition (IKC)
- KMAP Provider Training Materials
- Long-Term Care Application - KMAP guides for nursing facility workers who help patients apply for long-term care coverage under Medicaid/KanCare
10 Elements of Competence for Using Teach-back Effectively - Learn about the teach-back method, a research-based health literacy intervention that improves patient-provider communication and patient health outcomes.
Project ECHO Opportunities
- Visit the Sunflower Project ECHO page.
- University of Kansas Medical Center ECHOs