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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


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

December 3, 2018: Provider Manual Updated
The Kansas Medicaid Provider Manual has been updated. You can find a link to it on the Provider Resources page.

October 2, 2018: KMAP Bulletin Describes Process for Adjustments for Qualis Health Retrospective Review Findings
If you haven’t already, be sure to read KMAP Hospital & ASC Bulletin 18158, which outlines the process now in place for claim adjustments for denials identified by Qualis Health during retrospective review.

You can also find a link to the bulletin on the Provider Resources page under the heading “Provider Bulletins.”

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.



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Contact Us

»Qualis Health Provider Portal

»email Qualis Health Provider Portal Help

(877) 560-2619

(877) 717-8594


»Kansas Medical Assistance Program website

KMAP Provider Customer Service:
(800) 933-6593

»more contact information