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Kansas Department of Health and Environment, Division of Health Care Finance


In collaboration with the Kansas Department of Health and Environment, Division of Health Care Finance (KDHE-DHCF), Qualis Health will provide retrospective utilization review services. Our staff of qualified healthcare professionals will perform this work from our Topeka office.


Services We Provide for KDHE-DHCF’s Fee-for-Service Program

Qualis Health will conduct retrospective post-payment utilization reviews for these fee-for-service claims:

  • Inpatient hospital
  • Inpatient psychiatric hospital
  • Ambulatory surgical center


Announcements

Qualis Health will begin reviews for KDHE-DHCF on August 1, 2017. Please check this page frequently for updates about transition activities, including provider training.

July 20, 2017: Provider Manual and Webinar Slides Now Online
Our Kansas Medicaid provider manual is now online. You can also find a link to it on the Provider Resources page.

The slides from our July 19 webinar, “Introduction to Qualis Health and the Qualis Health Provider Portal,” have also been posted, and you can find them on the Provider Resources page. If you missed the July 19 event, we will be holding another session on July 25. Visit the Provider Education page for details.

July 14, 2017: Join Us for Qualis Health Provider Portal Trainings in July and August
Our July training webinar, “Introduction to Qualis Health and the Qualis Health Provider Portal,” will be held on July 19 from 2:00 to 3:00 pm and repeated on July 25 at the same time.

We are offering “Submitting Medical Records Using the Qualis Health Provider Portal” every Tuesday and Thursday in August from 2:00 to 3:00 pm. You only need to attend one of these sessions.

Find details about these events on the Provider Education page.

June 30, 2017: Message from Qualis Health’s Director of Kansas Medicaid Services, Patricia Counter, RN, BSN, CCM, ACM
Welcome to the Qualis Health website.

Although Qualis Health may be new to you, we aren’t new to Kansas. We’ve been working with primary care practices in the state to help them achieve their quality improvement goals for nearly a decade.

As a utilization review provider, our Medicaid experience spans more than 40 years. In addition to Kansas, we serve Medicaid agencies in Alabama, Alaska, the District of Columbia, New Mexico, Oklahoma, Washington and Wyoming.

Qualis Health is a nonprofit organization. We’re not here to benefit private shareholders. Rather, we are mission driven to improve the quality of healthcare delivery and health outcomes, and we are committed to carrying out our work in an objective, evidence-based and unbiased manner.

We are in close collaboration with KDHE-DHCF to ensure a smooth transition of services. I speak for myself and my team at Qualis Health when I say we are looking forward to working with you.

Contact Us

»Qualis Health Provider Portal

»email Qualis Health Provider Portal Help

Fax and phone numbers will be live beginning August 1.

Fax:
(877) 560-2619

Phone:
(877) 717-8594

Contact
KDHE-DHCF

»Kansas Medical Assistance Program website

KMAP Provider Customer Service:
(800) 933-6593


»more contact information