Medical Billing Services in Kansas.
Kansas launched KanCare 3.0 on January 1, 2025—the state’s third MCO contract cycle since transitioning to managed Medicaid in 2013. The new 5-year contracts brought a significant change: Aetna Better Health of Kansas was replaced by new entrant Healthy Blue (a Blue Cross Blue Shield affiliate), while incumbents Sunflower Health Plan (Centene) and UnitedHealthcare Community Plan were retained. Happy Billing guides Kansas providers through KanCare 3.0 credentialing, prior authorization, and the billing transition from Aetna to Healthy Blue for affected patient populations.
Kansas Medicaid (KanCare) Billing
KanCare covers more than 440,000 Kansans as of 2025. Kansas expanded Medicaid under the ACA effective January 1, 2020, following years of legislative defeats and a 2019 gubernatorial veto override attempt. The expansion brought approximately 150,000 additional Kansans into Medicaid eligibility. About 61% of KanCare enrollees are children and another 14% are parents or caretakers of children, making family and pediatric billing expertise especially important for Kansas providers.
KanCare 3.0 MCOs (Effective January 1, 2025)
Three managed care organizations provide KanCare services under the new 5-year contracts:
- Sunflower Health Plan (Centene subsidiary): Incumbent; one of two original KanCare plans since 2013; large statewide network and CentAccount Rewards Program for members; Provider Services: 1-877-644-4623
- UnitedHealthcare Community Plan of Kansas: Incumbent since KanCare launch; largest provider network in Kansas including hundreds of hospitals statewide; Provider Services: 1-877-542-9235
- Healthy Blue (Community Care Health Plan of Kansas, BCBS affiliate): New entrant replacing Aetna Better Health, effective January 1, 2025; Provider Services: 1-833-838-2595; previously credentialed providers were auto-enrolled through December 2024
KanCare Transition: Aetna Exit / Healthy Blue Entry
Aetna Better Health of Kansas was not selected for KanCare 3.0 after the state’s May 2024 MCO selection announcement. Key transition details:
- Special open enrollment ran October 1–December 17, 2024 for Aetna members to choose a new plan
- Aetna members who did not select a new plan were auto-assigned to Healthy Blue effective January 1, 2025
- Providers contracted with Aetna needed to credential with Healthy Blue separately; KMAP offered auto-enrollment for existing KMAP providers through December 27, 2024
- Additional special enrollment period ran January 1–April 4, 2025 for further plan changes
MediKan and Other Programs
- MediKan: Fully state-funded 12-month program for individuals applying for Social Security disability benefits who do not yet qualify for full KanCare; billed directly to state
- OneCare Kansas: Enhanced care management option for KanCare members with chronic conditions (diabetes, asthma, mental illness); adds home care and social supports on top of regular KanCare benefits
- CHIP: Covered under KanCare for children under 19 not eligible for Medicaid but with household income below 238% FPL
Key Billing Facts for Kansas Providers
- All three MCO networks are statewide—providers should credential with all three to serve the full KanCare population
- Centralized credentialing: KMAP provider enrollment is required before contracting with any MCO; single KMAP application enables credentialing with all three plans
- MCO rates: KanCare contracts require payment of at least 100% of FFS Medicaid rates to contracted providers
- Out-of-network: Providers not contracted with a KanCare MCO receive 90% of FFS rates
- Open enrollment: Annual 90-day open enrollment runs January–March each year; members can switch plans
- Provider enrollment: Kansas Medical Assistance Program (KMAP) portal at kmap-state-ks.com
Kansas's Major Health Systems
The University of Kansas Health System
The University of Kansas Health System (Kansas City, KS) is Kansas’s dominant academic medical center with NPR of $2.58 billion—more than three times the second-highest hospital in the state. The flagship University of Kansas Hospital (993 staffed beds) is ranked #1 in Kansas by U.S. News & World Report and ranked 40th in the nation by net patient revenue, making it the premier tertiary and quaternary care destination in the region. In 2024, the system had 1,753,607 outpatient visits, 62,579 inpatient admissions, and 133,093 emergency department visits. The system expanded significantly with new hospital affiliations in FY2024. It provides care through the KU Cancer Center (the only NCI-designated cancer center in Kansas), KU Heart & Vascular Institute, and a broad network of specialty services.
Stormont Vail Health
Topeka-based Stormont Vail Health is Kansas’s second-largest health system by hospital NPR at $825 million. The flagship Stormont Vail Hospital in Topeka serves as the primary tertiary care center for central and northeast Kansas. Stormont Vail operates Cotton O’Neil Medical Group (a large employed physician organization), multiple outpatient facilities, and a behavioral health campus. As the regional healthcare anchor for the Topeka metro and surrounding rural counties, Stormont Vail is a critical KanCare network provider for central Kansas.
Via Christi Health (CommonSpirit)
Wichita-based Via Christi Health is Kansas’s largest health system by number of hospitals, operating the Via Christi Hospitals Wichita St. Francis (878 beds, Wichita’s largest hospital) and multiple other facilities across south-central Kansas. Via Christi is part of CommonSpirit Health (the nation’s largest nonprofit health system) and provides tertiary care, cancer services, behavioral health, and community services to the Wichita metro and rural south-central Kansas. Via Christi St. Francis is a Level II Trauma Center and the primary teaching site for several residency programs in Wichita.
Why Kansas Practices Choose Happy Billing
KanCare 3.0’s launch on January 1, 2025 required Kansas providers to rapidly credential with a new MCO—Healthy Blue—while maintaining ongoing billing operations with Sunflower and UnitedHealthcare. The compressed timeline (Aetna exit announced May 2024, special open enrollment October–December 2024, go-live January 1, 2025) left many providers scrambling to credential and set up billing workflows with Healthy Blue before the effective date. Happy Billing managed this transition for Kansas clients—running parallel credentialing with all three KanCare MCOs, establishing Healthy Blue EDI and claims routing, and ensuring continuity of billing for Aetna-transitioning patients. We now provide ongoing KanCare 3.0 billing management across all three plans.
- KanCare 3.0 MCO billing for all three plans: Sunflower, UnitedHealthcare, Healthy Blue
- Aetna-to-Healthy Blue transition management and re-credentialing
- University of Kansas Health System and Stormont Vail network management
- MediKan state-funded program billing
- Rural health and Critical Access Hospital billing across Kansas’s extensive rural landscape
Is your Kansas practice leaving revenue on the table?
Specialties We Serve in Kansas
Each specialty page dives into the specific billing challenges and our approach. Visit our Specialties to explore the one most relevant to your practice.
Kansas Medical Billing FAQs
What is KanCare 3.0 and what changed from KanCare 2.0?
KanCare 3.0 is the third 5-year MCO contract cycle for Kansas Medicaid, effective January 1, 2025. The key change from KanCare 2.0: Aetna Better Health of Kansas was not selected and was replaced by Healthy Blue (a Community Care Health Plan of Kansas / BCBS affiliate). The two incumbents—Sunflower Health Plan (Centene) and UnitedHealthcare Community Plan—were retained. KanCare 3.0 also introduces new requirements around maternal and infant health, social determinants of health screening, and enhanced member dashboards for prenatal/postpartum quality measures.