Welcome to your daily briefing on healthcare developments in Kansas. Today we're covering 5 key stories including updates on kansas healthcare headlines, background & context. Let's dive in.
2 stories
The University of Kansas Health System explains the Kansas Open Records Act and how to request public records from the organization.j***@jocogov.orgXXX-XXX-XXXX
Healthcare professionals in KS who work with or contract with KU Health System should understand public records processes for compliance and transparency.j***@jocogov.orgXXX-XXX-XXXX
The Department of Health and Environment provides programs that protect public health and the environment, prevent disease, and promote wellness.j***@jocogov.orgXXX-XXX-XXXX
Healthcare professionals in KS can leverage these public health resources to coordinate patient care and community wellness initiatives.j***@jocogov.orgXXX-XXX-XXXX
Reach healthcare professionals
3 stories
Covered entities must annually recertify their 340B eligibility through HRSA. Missing the recertification window pushes the entity to inactive status, which means immediate loss of 340B pricing and potentially diversion violations on previously dispensed drugs. Reinstatement requires a new application.j***@jocogov.orgXXX-XXX-XXXX
The discount value of 340B pricing for a covered entity often exceeds six figures annually. Letting the recertification lapse for paperwork reasons is one of the most expensive administrative errors in the regulation.j***@jocogov.orgXXX-XXX-XXXX
Across most payors, the top-five denial reasons account for over 80% of prior-auth rejections: missing clinical documentation, wrong CPT/HCPCS code, service not in benefit plan, step-therapy not completed, and ordering provider not on the patient's plan. The same five repeat across plans because they are the easiest to deny on automation.j***@jocogov.orgXXX-XXX-XXXX
Practices that build a five-line pre-submission checklist around these reasons typically cut prior-auth denials by 40-60% within a quarter. The fix is process, not appeals capacity.j***@jocogov.orgXXX-XXX-XXXX
Three application defects routinely delay payor enrollment: incomplete work-history explanations for any gap over 30 days, a malpractice carrier-history that does not reconcile with the explanation, and CAQH attestation that has lapsed. Each forces a back-and-forth with the credentialing committee.j***@jocogov.orgXXX-XXX-XXXX
A new clinician without active payor enrollment cannot bill for covered services for most plans. Each month of delay is foregone revenue that does not retroactively recover.j***@jocogov.orgXXX-XXX-XXXX
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