Kansas Medicaid Fee-For-Service Utilization Review Manual

KFMC Health Improvement Partners is the Medicaid Fee-for-Service (FFS) utilization review (UR) contractor for the Kansas Department of Health and Environment Division of Health Care Finance (KDHE-DHCF) to perform utilization reviews to safeguard against unnecessary utilization of services and ensure efficiency, economy, and quality of care to Kansas Medicaid members.

Our primary functions include the operation of a review system to monitor the quality, diagnosis and procedure validation, medical necessity, discharge appropriateness, and appropriateness of health care provided.