In an effort to streamline the current KanCare credentialing process, an updated Kansas Organizational Provider Credentialing/Recredentialing Application is now available for use by all providers applying to a KanCare managed care organization (MCO). The new application became available May 1 and replaces previous versions and will be required for all applications received by the MCOs on and after June 1, 2017.

The form is required to be completed in its entirety only one time. For providers wanting to enroll with multiple MCOs, simply open the completed application, change their MCO attestation, print, and sign the application. An original, wet signature is required for each individual MCO. The updated application is also required for those providers needing to be re-credentialed.

The fillable PDF form is available here. The announcement and frequently asked questions are available on the KMAP website. If you have questions or would like to provide feedback about this new process please contact This email address is being protected from spambots. You need JavaScript enabled to view it., KMS Director of Health Care Finance.


logo kms

KaMMCO 2018

logo khc

logo khin