Children's Mercy Integrated Care Solutions
Case Management and Disease Management Referral Form
Our Care Team is here to support you and your patients. CMICS Network Providers, please click the button below to refer patients who may benefit from case management services. For any questions or issues, please contact providerrelations@cmpcn.org
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All other providers, please complete and submit this form (via Email/Fax; see Form) to refer patients who may benefit from case management services. For any urgent referral needs, or further questions, please call Care Integration at 888-670-7262.
Fillable Form
To submit case management exclusions, please click here. Important: Only applicable for CMHN Care Management services (i.e. commercial patients).
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2420 Pershing Road, Suite G10
P.O. Box 411596, Kansas City, MO 64141
888-670-7261
816-701-4525
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