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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 provides retrospective utilization review services. Our staff of qualified healthcare professionals performs this work from our Topeka office.


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

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

  • Inpatient hospital
  • Inpatient psychiatric hospital
  • Ambulatory surgical center


Announcements

Please check this page regularly for updates about provider training and resources.

August 18, 2017: New Qualis Health Provider Portal Guides Posted
We have added two new documents to our library of resources for the Qualis Health Provider Portal: a user guide and an administrator guide. You can also find these on the Provider Resources page.

August 18, 2017: Additional QHPP Training Webinars Offered in September
We have added three more sessions to the Qualis Health Provider Portal training schedule: September 13, 20 and 27 from 11:00 to 11:30 am central time. Get details on the Provider Education page.

August 3, 2017: August Webinar Slides Now Online
The slides for our August training sessions, “Attaching Documents and Communicating with Qualis Health through the Qualis Health Provider Portal,” have been posted. You can also find them on the Provider Resources page.

These webinars take place every Tuesday and Thursday afternoon in August, so if you haven't yet attended, there's still plenty of time. Visit the Provider Education page for details.

July 26, 2017: Quick Start Guides Available to Help You Use the QHPP
Four new Quick Start Guides give specific instructions for common tasks in the Qualis Health Provider Portal: Attaching Documents, Checking the Status of Your Review, Communicating with Qualis Health, and Searching for a Member. You can also find these guides on the Provider Resources page in the “Qualis Health Provider Portal Resources” section.

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 “Attaching Documents and Communicating with Qualis Health through 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:
(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