Because you Asked
Originally published 09:07 a.m., May 17, 2008
Updated 09:07 a.m., May 17, 2008
Q If a child needs treatment by a specialist not available in Emporia, or needs procedures done that are not available here, does HealthWave pay for those types of things to be done out-of-town?
A The Managed Care Organizations (MCOs) the Kansas Health Policy Authority contracts with — Children’s Mercy Family Health Partners and UniCare Health Plan of Kansas — are required to develop a comprehensive network including specialty care, according to Frances Breyne, attorney and KPHA communications director.
“If a member requires medically necessary services from a specialist that is not within the MCO’s network, the MCO is required to reimburse a provider for that need out of network,” Breyne said. “Many specialists gravitate to the urban centers across Kansas. As Kansas is a rural state, many Kansans, whether they are private pay or Medicaid, must travel to those urban centers to receive specialty care.”
Q Does HealthWave provide any funds for traveling to and from appointments or treatments?
A “Yes,” Breyne said. “Transportation to out-of-town appointments, as well as some in-town appointments, is available for members assigned to the MCOs as well as Medicaid Fee-For-Service.”
Breyne added that for transportation to be covered, it must be provided for a Medicaid covered and medically necessary service, and it must be provided by a Kansas Medicaid-enrolled Medicaid provider.