Resources: Quick Guides, Office Forms, Helpful Links

Forms, Quick Guides, FAQs

Prior Auth Requirements for KS PCN Members

Prior Auth Code Lookup for KS PCN Members

Care Integration Program Guide

Case Management Quick Guide

Community Engagement Resource Application (CERA)

EPR-3 Asthma Guidelines

Healthy Habits Assessment

Healthy Habits Assessment - Spanish

NICHQ Healthy Care for Healthy Kids Toolkit

Utilization Management Plan

Forms:

Prior Auth Form

Prior Auth Form (fillable)

Private Duty Services Prior Auth Form

PCP Change Form

Referral Form
To refer a PCN member to a Disease Management Specialist, fill out this form or call Care Integration:
1-888-670-7262.

Pregnancy Notification:

Missouri Providers:
Once you have identified a PCN Missouri member is pregnant, please complete the Notification of Pregnancy via the MHD NOP and Risk Screening Portal.

Kansas Providers:
Once you have identified a PCN Missouri member is pregnant, please complete the Pregnancy Notification Form and submit to PCN.

Helpful Links

Autism Speaks: 100 Day Kit for Newly Diagnosed Families of School Age Children

CDC: Vaccine Conversations with Parents

Children's Mercy Child Health Library

Children's Mercy Health Sciences Library

Greater Kansas City Medical Managers Association

Immunization Action Coalition

Individualized Education Plan (IEP) and Individualized Family Service Plan (IFSP)

KanCare

Kansas Medical Assistance Program (KMAP)

Missouri Care Member Handbook

MO HealthNet for Kids

Northland Medical Managers

UnitedHealthcare Member Handbook

Lift Up KC

Access Lift Up KC, Children’s Mercy Kansas City’s tailored social care platform and directory powered by findhelp. Lift Up KC is simple, free, and can help connect patients and families in need of a little help. With just a zip code (no registration required), users can find hundreds of social need programs in their area to address food instability, housing instability & utility needs, transportation, job support, and much more.

In Partnership with CMH PCN