KMAP Provider Enrollment and Kansas Medicaid Credentialing: the Enrollment Wizard, KanCare MCOs, Status Codes and WPS Medicare
KMAP provider enrollment is the Kansas Medicaid application you file in the Kansas Medical Assistance Program's online Provider Enrollment Wizard, and in Kansas it is also the doorway to the KanCare managed care plans: you choose Sunflower Health Plan, UnitedHealthcare Community Plan or Healthy Blue on the same application, and KMAP forwards your approved file to them. No KanCare plan will contract with or pay a location that lacks a KMAP ID. Medicare is a separate file, filed in PECOS and processed by WPS Government Health Administrators (Jurisdiction 5).
Updated October 23, 2026. Each rule below links to the KMAP bulletin, KMAP page, federal rule or CMS page it comes from, with the bulletin date. KMAP's own bulletin PDFs sit behind a login redirect for automated readers, so several are linked to the verbatim reprints KanCare plan Sunflower Health Plan posts; the bulletin numbers are KMAP's. Where Kansas publishes nothing, we say so. This is not legal advice.
We enroll providers with KMAP and credential them with the KanCare plans, Medicare and the commercial payers as one file. If you would rather not run the Wizard yourself, start credentialing now; we send a secure start link within one business hour.
Kansas Medicaid Credentialing at a Glance
Kansas folds more into one application than most states, but the files are still separate decisions. Only standards someone has actually published appear in the third column.
| Program | Decided by | Published standard or rule | Source |
|---|---|---|---|
| KMAP enrollment (Kansas Medicaid fee-for-service and the KMAP ID) | KMAP provider enrollment, Gainwell Technologies as fiscal agent | No processing time published; eight defined application statuses | KMAP Enrollment Status |
| KanCare MCO contracting and credentialing | Sunflower Health Plan, UnitedHealthcare Community Plan, Healthy Blue | KMAP ID required first; MCOs chosen in the Wizard; Section 12 form for all provider types | Bulletin 24215, Bulletin 21185 |
| Fingerprint background check (high-risk only) | KDHE Division of Health Care Finance | 5 to 10 business days after prints are received | KDHE FCBC Q&A |
| KMAP revalidation | KMAP | At least every five years (federal); MCO recredentialing date reset to match | 42 CFR 455.414, Bulletin 20209 |
| Medicare Part B | WPS GHA (J5 A/B MAC) | CMS standard for all MACs: online, no site visit, 95% within 15 calendar days, all within 50 | CMS Program Integrity Manual ch. 10 |
KMAP Provider Enrollment in the Provider Enrollment Wizard
Every Kansas Medicaid application starts in the KMAP Provider Enrollment Wizard. KMAP General Bulletin 19115 (September 24, 2025) restates the federal managed care rule in Kansas terms: KanCare MCO network providers who receive payment for KanCare members "are required to be screened and enrolled" in KMAP. The Wizard offers three paths, and choosing the wrong one is a common source of rework:
| Wizard path | Use it when | Bulletin 19115 wording |
|---|---|---|
| New Enrollment | A new provider, an additional service location, or a brand-new location | "should be used to add an additional service location or a brand new location" |
| MCO Contract Request Form | KMAP already has the location, but a KanCare plan does not | "should be used when the service location is not known to the KanCare MCO but is already enrolled with KMAP" |
| Revalidation | Only after KMAP sends you a revalidation notice | "should only be used after a revalidation notification is received from KMAP" |
At submission the Wizard issues a tracking number, and you set a password. Write both down with the date: they are the only way into the status screen, and KMAP Bulletin 20209 describes the same tracking number as the link between your KMAP file and the documents you send the MCOs.
Choose the enrollment type carefully. Since dates of service on and after June 1, 2024, KMAP Bulletin 24095 (May 28, 2024) requires the ordering or referring NPI on a claim to carry an enrollment type of Individual (I), Individual within a Group (IG), or Ordering, Referring, Prescribing (ORP); claims naming an ordering or referring NPI with any other enrollment type are denied (hospice, provider type/specialty 06/060, is exempt). A physician who only orders or refers for Kansas Medicaid patients can enroll as ORP rather than as a billing provider.
Choosing KanCare MCOs Inside Your KMAP Application
This is the Kansas feature most practices miss. KMAP Bulletin 24215 (October 29, 2024) says providers join the plans "by submitting an application in the Provider Enrollment Wizard" and "selecting MCO(s) at the time of enrollment." KMAP reviews the application first; when it is approved and you asked for plan participation, the status becomes Submitted to Managed Care, which KMAP defines as "forwarded to MCOs for contracting."
Three plans hold KanCare contracts from January 1, 2025 through December 31, 2027, per KMAP Bulletin 24118 (June 6, 2024): Sunflower Health Plan and UnitedHealthcare Community Plan, the two incumbents, and Healthy Blue, the new entrant. The bulletin names no other incumbent, so a contract with any former KanCare plan does not carry into this cycle. Healthy Blue's onboarding auto-enrolled providers already contracted with it who were active in KMAP through December 27, 2024; after that date, Bulletin 24215 says, everyone follows the normal KMAP process to add Healthy Blue.
The rules on the plan side are blunt. Bulletin 24215 says providers "are required to have a KMAP identification (ID) number to participate with the MCOs," and that failing to enroll an active KanCare network service location "will result in denial of claims." KMAP Bulletin 17295 (December 21, 2017) adds that a provider cannot recredential or start a new network agreement with a KanCare MCO until it has a KMAP ID. Every service location counts separately: a second office opened under an existing contract still needs its own KMAP enrollment before the plans will pay claims from it.
KanCare Credentialing Forms: Section 12 and the Joint Credentialing Application
Kansas standardized part of MCO credentialing inside KMAP. KMAP Bulletin 21185 (October 25, 2021) made three documents available through the Wizard and required by provider type and specialty:
- Section 12 Attestation/Consent and Release Form: required for all provider types and specialties when enrolling with any KanCare MCO and when credentialing.
- Kansas Org Provider Cred/Recred Application (the "Joint Credentialing Application"): required before credentialing for psychiatric hospitals (PT01/PS011), custodial care facilities (PT03), mental health and substance use disorder providers (PT11/176) and psychiatric residential treatment facilities (PT11/232).
- HCBS Supplemental Form: required before credentialing for targeted case management (PT21), home and community based services (PT55) and WORK (PT56) providers.
The bulletin sends questions about completing these forms to the MCO, not KMAP, and notes that each plan's implementation date may differ from KMAP's. In practice an unsigned or outdated Section 12 is enough to hold an application after KMAP approves it, because the plans need it before they credential.
Revalidation and recredentialing are tied together in Kansas. KMAP Bulletin 20209 (October 13, 2020) says the MCO "will reset the next recredentialing due date to match the KMAP revalidation due date," for new enrollments as well as revalidations, and the MCO notifies the provider of the aligned date.
KMAP Enrollment Status: All Eight Statuses Explained
To check KMAP enrollment status, go to the Enrollment Status page and enter the tracking number and password used on the application. KMAP defines each status this way:
| Status | KMAP's definition | What to do |
|---|---|---|
| Partial/Started | Started but not submitted; also a generated revalidation awaiting the provider | Finish and submit before it expires |
| Awaiting Attachments | Submitted, waiting for required attachments or documents | Send the missing documents; review has not begun |
| Submitted | Complete and submitted for review | Wait; nothing is missing |
| Pending | Queued for the enrollment team | Wait |
| RTP (Returned to Provider) | Requires corrections; a separate notice lists the issues | Fix every item on the notice and resubmit |
| Approved | Approved; written confirmation follows | Watch for the plan hand-off if you chose MCOs |
| Expired | Not submitted within the allowable timeframe | Start a new application |
| Submitted to Managed Care | Forwarded to the MCOs for contracting | Follow up with each plan's credentialing team |
Customer service for status questions is Gainwell Technologies at 1-800-933-6593, 8 a.m. to 5 p.m. Monday through Friday, or Kansas-Provider-Enrollment@gainwelltechnologies.com. KMAP publishes no target processing time on the pages we read, so the status itself is the best progress measure.
Screening and Fingerprints for Kansas Medicaid
Kansas screens every application by the federal risk categories in 42 CFR Part 455, subpart E. KDHE's fingerprint background check Q&A (August 2016) explains how the high-risk tier works in Kansas:
- Who is high risk: DME suppliers and home health agencies enrolled after March 2011, plus any provider under a payment suspension for a credible allegation of fraud, with an existing Medicaid overpayment, or excluded by the OIG or another Medicaid program in the previous 10 years.
- Who is fingerprinted: the provider and anyone with a direct or indirect ownership interest of 5 percent or more.
- Where: any law enforcement agency authorized to take prints, inside or outside Kansas. The agency mails the card to KDHE/DHCF in the stamped, addressed envelope you supply; if it will not mail it, find one that will.
- How long: the background check takes 5 to 10 business days once KDHE receives the prints.
- Medicare shortcut: KDHE may rely on Medicare's screening for a high-risk provider enrolled in Medicare after matching the provider in PECOS, under 42 CFR 455.410(c).
Physicians in ordinary practice are not on the high-risk list, so most never see a fingerprint request.
The KMAP Application Fee
KMAP Bulletin 23333 (December 29, 2023) explains how Kansas collects the federal fee: it applies to new provider applications, re-enrollments (revalidations) and reactivations, it is charged for each provider type, and it is paid by check or money order payable to the State of Kansas - Medicaid. A missing or unacceptable payment sends the paperwork back, and the fee is not refunded if the application or revalidation is denied.
Exempt: individual practitioners, non-physician practitioners and groups; providers already enrolled with Medicare; providers that already paid the fee to Medicare or another state Medicaid program; and the provider types marked exempt in the bulletin's matrix. The fiscal agent verifies Medicare enrollment or payment in PECOS before waiving it. Kansas set $709 for 2024 in that bulletin; for calendar 2026, CMS set the federal fee at $750 (CMS-6096-N, December 3, 2025). We did not find a 2026 KMAP fee bulletin, so confirm the amount with KMAP before mailing a check.
KMAP Revalidation
Federal rule 42 CFR 455.414 requires each state Medicaid agency to revalidate every provider at least every five years. KMAP paused revalidations during the public health emergency and resumed them after it ended on May 11, 2023 (Bulletin 23124, May 8, 2023, which also notes the federal application fee requirement came back April 1, 2023).
KMAP General Bulletin 24013 (January 2024) is the operating guidance:
- "Every KMAP provider must complete a revalidation to remain enrolled in the Kansas Medicaid program," and failure to revalidate terminates KMAP enrollment.
- Notices go to the email and mailing address on file, so log in to the provider portal and confirm them now.
- Enter your name exactly as it was entered at enrollment.
- If you are affiliated with several entities, the entity that enrolled you receives your revalidation; ask KMAP if you do not know which one.
The revalidation itself is generated by KMAP and appears as Partial/Started until you review and submit it, which is why an ignored notice can expire into a termination without anyone at the practice seeing a single screen.
Medicare in Kansas: WPS Government Health Administrators, Jurisdiction 5
Kansas Medicare Part A and Part B claims and enrollment run through Wisconsin Physicians Service Government Health Administrators (WPS GHA). CMS's Jurisdiction 5 page (last modified July 8, 2026) lists WPS GHA as the J5 A/B MAC for Iowa, Kansas, Missouri and Nebraska. You file the CMS-855I (individuals, with reassignment) or CMS-855B (groups) in PECOS, and WPS issues the PTAN and effective date.
The processing standard is CMS's, applied to every MAC in the Program Integrity Manual, chapter 10:
| Application | 95% processed within | All processed within |
|---|---|---|
| Web (PECOS), no site visit, development request or fingerprinting | 15 calendar days | 50 calendar days |
| Web (PECOS), with any of those | 50 calendar days | 85 calendar days |
| Paper, with none of those | 30 calendar days | 65 calendar days |
| Paper, with any of those | 65 calendar days | 100 calendar days |
Under 42 CFR 424.521, physicians and non-physician practitioners can bill Medicare for services up to 30 days before their effective date when circumstances kept them from enrolling sooner (90 days after a Presidentially declared disaster); earlier visits are not billable. A Medicare enrollment also helps on the Medicaid side: KMAP waives the application fee for Medicare-enrolled providers and KDHE can rely on Medicare's screening. Kansas patients with Railroad Retirement Board coverage need a separate Railroad Medicare PTAN, covered on our Railroad Medicare provider enrollment page; the complete Medicare process is on Medicare provider enrollment.
Commercial Plans and CAQH in Kansas
We searched for a Kansas statute or regulation that sets deadlines for commercial insurers to finish credentialing, the kind Arkansas and Kentucky write into law, and did not find one. Treat each commercial plan's own published process as the standard, and get the plan's acknowledgment in writing with a date.
Where a plan reads your CAQH profile, CAQH asks providers to re-attest every 120 days (CAQH quick reference); a lapsed attestation stops every plan using it at the same moment. Our CAQH explained page covers setup, and the payer-by-payer credentialing hub covers the national plans' own steps.
Why Kansas Medicaid Applications Stall
Most stalls start with bad data from the provider side. KMAP's own rules show where:
- The wrong Wizard path. A New Enrollment filed for a location KMAP already has, when the plan only needed an MCO Contract Request Form, or a revalidation started without a notice.
- MCOs not selected. Approval without plan selection leaves you enrolled in KMAP and out of every KanCare network.
- A missing Section 12 form. Required for every provider type before the plans credential.
- An unenrolled second location. Claims from it are denied even under an existing plan contract.
- An RTP notice left unanswered, or an application left in Partial/Started until it Expires.
- Old contact details. Revalidation notices go to the email and address on file; a former office manager's inbox means a termination nobody saw coming.
- A name typed differently from enrollment. KMAP requires it to match exactly at revalidation.
- The wrong enrollment type for an ordering physician, which denies the claims of the providers relying on that order.
So we check every field across the KMAP application, NPPES, the license, CAQH and each plan's request before submitting, and then follow up with KMAP and each plan weekly, logging the representative's name, the date and the reference number.
What to Gather Before Starting a Kansas File
KMAP, the KanCare plans, Medicare and the commercial payers all draw on the same records: individual and group NPIs with current NPPES addresses, the IRS letter with the legal name and tax ID, the Kansas license with its dates, DEA if applicable, board certification if any, malpractice certificate, bank information for payment, ownership and managing-employee details (anyone at 5 percent or more matters for screening), every service location, a signed Section 12 form, a current CAQH profile, and the Medicare approval letter once issued. The full list and how to send it securely are on what we need from you to start credentialing.
For the difference between credentialing, enrollment and contracting, see what provider credentialing is. Federal Medicaid enrollment rules that apply in every state are on Medicaid provider enrollment, and the other state guides include provider credentialing in Florida and provider credentialing in Kentucky.
Frequently Asked Questions
What is KMAP provider enrollment?
KMAP is the Kansas Medical Assistance Program, the Kansas Medicaid program administered for the Kansas Department of Health and Environment, with Gainwell Technologies as its fiscal agent. KMAP provider enrollment is the application in KMAP's online Provider Enrollment Wizard that screens a provider and issues the KMAP ID every KanCare managed care plan requires before it will contract or pay.
Do I have to enroll with KMAP to join a KanCare MCO?
Yes. KMAP General Bulletin 24215 (October 29, 2024) says KanCare MCO providers must be enrolled by KMAP before contracting and must have a KMAP ID to participate, and that an active KanCare service location not enrolled with KMAP will have its claims denied. An earlier bulletin adds that an MCO cannot recredential you or start a new network agreement until you have a KMAP ID.
How do I pick Sunflower, UnitedHealthcare or Healthy Blue in KMAP?
You select the MCOs inside the Provider Enrollment Wizard when you apply. Once KMAP approves the application, its status changes to Submitted to Managed Care, meaning it was forwarded to the plans you chose for contracting. If KMAP already has your location but an MCO does not, use the MCO Contract Request Form in the Wizard instead of a new enrollment.
How long does KMAP provider enrollment take?
KMAP does not publish a processing time on the pages we read. What it does publish is the status sequence, so you can see where the file is: Partial/Started, Awaiting Attachments, Submitted, Pending, RTP (returned for corrections), Approved, Expired, and Submitted to Managed Care. Fingerprint-based background checks, when required, take 5 to 10 business days after KDHE receives the prints.
How do I check my KMAP application status?
Open the KMAP Enrollment Status page and enter the tracking number and the password you set on the application. For help, Gainwell's customer service team is at 1-800-933-6593, 8 a.m. to 5 p.m. Monday through Friday, or Kansas-Provider-Enrollment@gainwelltechnologies.com.
Does Kansas Medicaid charge physicians an application fee?
No. KMAP Bulletin 23333 exempts individual practitioners, non-physician practitioners and groups, plus providers already enrolled with Medicare or that already paid the fee to Medicare or another state Medicaid program. Fee-paying provider types pay by check or money order to the State of Kansas - Medicaid, and the fee is not refunded if the application is denied. The federal amount for calendar 2026 is $750.
How often do KMAP providers revalidate?
Federal rule 42 CFR 455.414 requires each state to revalidate every provider at least every five years. KMAP Bulletin 24013 (January 2024) says every KMAP provider must revalidate to stay enrolled, that notices go to the email and mailing address on file, and that failure to revalidate ends KMAP enrollment. Use the Revalidation application only after a KMAP notice arrives.
Does KMAP revalidation affect my MCO recredentialing?
Yes. KMAP Bulletin 20209 says the KanCare MCO resets your next recredentialing due date to match your KMAP revalidation date, and providers who recently recredentialed with an MCO did not have to repeat it for the current revalidation cycle. Keeping the KMAP record clean therefore keeps the MCO cycle aligned.
Who is the Medicare contractor for Kansas?
Wisconsin Physicians Service Government Health Administrators (WPS GHA), the A/B Medicare Administrative Contractor for Jurisdiction 5, which CMS lists for Iowa, Kansas, Missouri and Nebraska. You enroll in PECOS, and WPS processes the application and issues the PTAN.
What forms does KMAP require for MCO credentialing?
KMAP Bulletin 21185 made the Section 12 Attestation/Consent and Release Form required for every provider type enrolling with any KanCare MCO. Hospitals (psychiatric), custodial care facilities, mental health and substance use disorder providers and psychiatric residential treatment facilities also file the Kansas Org Provider Cred/Recred Application, and targeted case management, HCBS and WORK providers file an HCBS Supplemental Form.
Kansas Provider Credentialing Services
ClaimCarePro enrolls providers with KMAP, selects and follows up the KanCare plans (Sunflower, UnitedHealthcare Community Plan and Healthy Blue), and credentials with WPS Medicare and the commercial payers as one checked file, followed up weekly and logged. Flat pricing: $250 per payer application per provider, CAQH setup $250, re-credentialing $250, maintenance $99 per provider per year, or the new-practice bundle at $1,750 per provider ($1,400 each additional provider on the same group and payers). To begin, start credentialing now; a secure start link arrives within one business hour, and the phone line is (844) 772-8902. What the service includes is on provider credentialing services; keeping a Kansas file current after approval is on recredentialing.
Sources
Updated October 23, 2026. Each Kansas source below was read on October 23, 2026 unless another date appears beside it. KMAP bulletins marked "reprint" were read in the verbatim copy Sunflower Health Plan, a KanCare MCO, posts with the KMAP bulletin number and date, because KMAP's own PDF links redirect automated readers to a login. If KMAP or a plan changes what it publishes, its page governs. Nothing here is legal advice.
- KMAP, Provider Enrollment Wizard: portal.kmap-state-ks.us; Enrollment Status (status definitions, contacts, hours): portal.kmap-state-ks.us
- KMAP General Bulletin 19115, Updated Managed Care Rule Provider Enrollment (September 24, 2025), reprint: sunflowerhealthplan.com
- KMAP General Bulletin 24215, Healthy Blue Available for Provider Enrollment (October 29, 2024), reprint: sunflowerhealthplan.com
- KMAP General Bulletin 24118, KanCare MCO selection (June 6, 2024), reprint: sunflowerhealthplan.com
- KMAP General Bulletin 24095, Ordering or Referring NPI Enrollment Type Requirements (May 28, 2024), reprint: sunflowerhealthplan.com
- KMAP General Bulletin 24013, Don't Forget to Revalidate (January 2024), KMAP PDF: kmap-state-ks.us
- KMAP General Bulletin 23333, Provider Application Fee Change 2024 (December 29, 2023), reprint: sunflowerhealthplan.com
- KMAP General Bulletin 23124, Provider Revalidation Reminder (May 8, 2023), reprint: sunflowerhealthplan.com
- KMAP General Bulletin 21185, New Forms Available Through PE Wizard (October 25, 2021), reprint: sunflowerhealthplan.com
- KMAP General Bulletin 20209, Provider Revalidation Clarification (October 13, 2020), reprint: sunflowerhealthplan.com
- KMAP General Bulletin 17295, Provider Enrollment Managed Care Changes (December 21, 2017), reprint: sunflowerhealthplan.com
- KDHE, Fingerprint-based Criminal Background Checks Q&A (August 2016): kmap-state-ks.us
- 42 CFR 455.414, revalidation of enrollment ("at least every 5 years"), eCFR: ecfr.gov (text read in the Cornell LII copy; eCFR blocked our reader)
- CMS, Who are the MACs: A/B MAC Jurisdiction 5 (last modified July 8, 2026): cms.gov
- CMS-6096-N, provider enrollment application fee for CY 2026 (Federal Register, December 3, 2025): govinfo.gov
- CMS, Medicare Program Integrity Manual, chapter 10 (read October 23, 2026 for our Medicare enrollment page): cms.gov
- 42 CFR 424.521, eCFR (read October 23, 2026 for our Medicare enrollment page): ecfr.gov
- CAQH ProView Provider Quick Reference (read October 16, 2026 for our CAQH page): caqh.org
Not found, and therefore not stated: a KMAP enrollment processing time, a 2026 KMAP application-fee bulletin, the current KMAP provider manual's enrollment chapter, any Kansas statute or regulation setting commercial credentialing deadlines, a current WPS GHA enrollment phone line, and published credentialing timelines from Sunflower, UnitedHealthcare Community Plan or Healthy Blue.
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