Navigating Kansas Medicaid: Overcoming the Hurdles for Home Care Growth
As of July 1, 2024, the Kansas Department of Health and Environment has increased reimbursement rates for home care services. With one of the highest rate limits in the country and a booming market, Kansas Medicaid presents an excellent opportunity for home care agencies. However, providers may find themselves hindered by the administrative burdens of navigating multiple complex systems. Challenges such as intricate billing processes and Electronic Visit Verification (EVV) requirements can divert attention from growth and success. Paradigm tackles these challenges by easing the administrative load. Our solutions simplify billing, optimize EVV data management, and more, allowing agencies to concentrate on maximizing their market potential and making a meaningful impact on their clients' lives.
How Paradigm Helps.
Billing
Enrollments
Eligibility
EVV Support
Training
MedicaidinKansas.
Electronic Visit Verification
Electronic Visit Verification (EVV) is a technology that confirms whether home or community-based service visits take place. Its purpose is to ensure that services are provided to care recipients as intended and that providers only bill for services actually delivered.
Providers often find EVV systems confusing and complex, and in Kansas, this confusion is compounded due to the unorthodox EVV model in use. Here we break things down to help you understand:
EVV Requirements:
The state of Kansas has a closed-external model. This means providers may select any third-party EVV vendor, but it must still aggregate to the state-selected system AuthentiCare. EVV is open (third party systems allowed), but billing is closed (billing must end up going through Authenticare).
EVV Aggregator:
AuthentiCare handles the transmission of all EVV data to the payer. Claims must follow EVV guidelines to ensure compliance and prevent payment and audit issues.
Billing Process:
Providers submit claims through KMAP portal, directly to MCOs, or through established clearinghouses.
Rates
Kansas Medicaid reimbursement rates were increased as of July 1, 2024. The updated rates range between $19.52 and $33.24 and are some of the highest in the country.
Providers must exercise caution, however, as Managed Care Organizations (MCOs) will often contract with providers at lower rates. Providers must meticulously review these individually negotiated contracts to ensure ideal reimbursement rates.
Payers
KMAP is the Kansas Medicaid program and authorizes all Medicaid for the state, offering a variety of waiver programs.
Click here for a comprehensive list of waivers with personal care service coverage.
KanCare is the Medicaid program which oversees all MCOs (Managed Care Organizations).
Kansas has three selected MCOs:
- Aetna
- UnitedHealthcare
- Sunflower
