Our training

We make sure providers have the right tools and resources to take care of our members. On this page, you’ll find helpful links and training opportunities to boost your knowledge and serve your community.

Questions?

Just call Provider Experience at 1-855-221-5656 (TTY: 711). We’re here for you Monday through Friday, 8 AM to 5 PM.

Getting started

Getting started

When you join our network, we’ll provide an initial orientation. After that, you’ll have ongoing training and education, including webinars, periodic provider newsletters and bulletins, and so much more.

Questions about joining our network? Just visit the join our network page for more information.

You can also check the quick reference guide or the provider manual for answers to many of your questions. Or you can call us at 1-855-221-5656 (TTY: 711).

Quick reference guide (PDF)

Provider manual (PDF)

New provider training and resources

Take part in a session and we’ll share helpful information, including:

• Contract requirements and amendments

• Special needs of the members served by the provider

• Service coverage guidelines

• Prior authorizations

• Billing procedures and claim submission

• How to learn more about your provider portal and other information

How to join

You can register to join an orientation training session. If you have questions, you can email us. Or call 1-855-221-5656 (TTY: 711).

Upcoming sessions

March 7, 2024 from 10 AM to 11 AM — Register here
June 6, 2024 from 10 AM to 11 AM — Register here
Sept 5, 2024 from 10 AM to 11 AM — Register here
December 5, 2024 from 10 AM to 11 AM — Register here

You can join the rest of our provider community by attending our provider town halls.

How to join

You can register to join a town hall. Just choose a date to register.

Upcoming sessions

May 17, 2024, 10 AM – 11 AM — register for this date

Questions? Just email us. Or call 1-855-221-5656 (TTY: 711).

Availity® training

The Provider Portal is an online tool that lets us communicate health care information directly to providers. In 2021, we transitioned from the Medicaid Web Portal (MWP) to Availity as our Provider Portal.

You need to register for the Availity Provider Portal before you can start using its many features. To learn more about how to register for the Availity Provider Portal, just visit the Provider Portal page.

Get training on Availity

Setting up your account with Availity (PDF)

Other training, materials and resources

You can take part in our provider refresher course to review helpful information including:

Contract requirements and amendments
Members’ special needs and how you can serve them
Service coverage guidelines
Prior authorizations
Billing procedures and claim submission
How to find more resources and information

Staff can also answer any of your questions about other topics, such as the provider portal.

How to join a training session

All sessions are held virtually. You can register to join a Provider 101 Refresher training session. Just choose a date for an upcoming session.

Upcoming sessions

March 14, 2024 from 10 AM to 11 AM — Register here
June 13, 2024 from 10 AM to 11 AM — Register here
September 12, 2024 from 10 AM to 11 AM — Register here
December 12, 2024 from 10 AM to 11 AM — Register here

Questions? Just email us. Or call 1-855-221-5656 (TTY: 711).

We strongly encourage all providers to learn more about cultural competency. Patient satisfaction and positive health outcomes are directly related to good communication, in a culturally competent manner, between a member and their provider.  

Providers should receive education about topics, such as:

The reluctance of certain cultures to discuss mental health issues and the need to proactively encourage members from such backgrounds to seek support
The impact that a member’s religious and/or cultural beliefs can have on health outcomes (example: belief in non-traditional healing practices)
Health illiteracy and the need to provide patients with understandable health information (example: simple diagrams, communicating in the vernacular, etc.)

History of the disability rights movement and the progression of civil rights for people with disabilities

Physical and programmatic barriers that impact people with disabilities accessing the right care

More about cultural competency

How to join a training session

You can register to join a cultural competency training session.

Upcoming sessions

March 21, 2024 from 10 AM to 11 AM — Register
June 20, 2024 from 10 AM to 11 AM — Register
September 19, 2024 from 10 AM to 11 AM — Register
December 19, 2024 from 10 AM to 11 AM — Register

You can register to join an orientation session through the individual registration links below. If you have questions, you can email us Or call 1-855-221-5656 (TTY: 711)

More resources

Cultural competency plan (PDF)

Cultural competency training presentation (PDF)

EPSDT services are a comprehensive array of prevention, diagnostic and treatment services for low-income infants, children and adolescents under age 21 (as specified in Section 1905(r) of the Social Security Act). The EPSDT benefit is more robust than the Medicaid benefit for adults and is designed to assure that children receive early detection and care, so that health problems are averted or diagnosed and treated as early as possible.

We’re committed to ensuring that the children we serve will receive health care they need when they need it, in the right setting. Our webinar covers all aspects of an EPSDT exam including best practices related to EPSDT services.

How to join a training session

You can register to join an EPSDT training session. Just choose your preferred session date to register.

Upcoming sessions

February 22, 2024 from 12:00 PM to 12:30 PM — register for this date
May 16, 2024 from 12:00 PM to 12:30 PM — register for this date

If you have questions about EPSDT or this presentation, please email the Aetna Better Health of Kansas Quality Management Department at ABHKS_QM_Operations@aetna.com

No.	TIME CODE	CAPTION
1	00:00:02:17	Welcome to the webinar.
2	00:00:05:00	Today, I will be presenting a general overview
3	00:00:08:00	of the EPSDT program
4	00:00:10:06	and how Aetna Better Health of Kansas can support your practice
5	00:00:13:17	as they navigate the EPSDT benefit for children on Medicaid.
6	00:00:21:00	So first, let's review what EPSDT means.
7	00:00:26:00	You'll find the acronyms spelled out on the slide.
8	00:00:30:03	Here we have E for early,
9	00:00:32:06	as in assessing for and identifying potential health concerns
10	00:00:36:09	on a timely basis.
11	00:00:38:16	Periodic,
12	00:00:40:00	monitoring overall health at age-appropriate times.
13	00:00:44:16	Screening, providing appropriate screening tests.
14	00:00:49:03	Diagnosis, includes follow up and referrals
15	00:00:53:05	when a health risk is identified.
16	00:00:56:03	And treatment, meaning correction, reduction,
17	00:00:59:19	or maintenance of health problems identified.
18	00:01:03:09	As a reminder, EPSDT is a federally-mandated benefit
19	00:01:07:13	that supports children throughout their growing years
20	00:01:10:09	in order to ensure they receive the care they need
21	00:01:13:03	by supporting their physical health, mental health, and development.
22	00:01:17:23	Note that Kansas follows
23	00:01:19:11	the American Academy of Pediatricians' Bright Futures periodicity schedule
24	00:01:24:16	regarding recommended visited timeline.
25	00:01:33:11	EPSDT covers children from birth up to the age of 21
26	00:01:38:05	and includes children in the foster care system.
27	00:01:41:22	Members do not sign up for this program.
28	00:01:44:11	They are automatically enrolled if they meet the age requirement.
29	00:01:49:00	In the same way, members cannot opt out of EPSDT.
30	00:01:54:11	They KanBeHealthy exam, or the KBH, is the starting point for EPSDT.
31	00:02:00:20	In other words,
32	00:02:01:23	this is how most members will access the benefit.
33	00:02:06:08	The KBH begins the process of screening children,
34	00:02:09:19	and the vast majority of children
35	00:02:11:13	may not need the other services EPSDT covers.
36	00:02:15:19	However, without regular KBHs,
37	00:02:20:20	conditions that are treatable may be missed.
38	00:02:30:20	This slide lists out the benefits of an annual KanBeHealthy visit.
39	00:02:37:08	We have making sure required health care resources
40	00:02:41:16	are available and accessible.
41	00:02:45:13	It assists families by helping Medicaid recipients
42	00:02:49:11	and their parents or guardians
43	00:02:50:20	effectively identify and use these resources,
44	00:02:54:20	by assessing the individual child's needs
45	00:02:57:11	through initial and periodic examination and evaluation,
46	00:03:02:06	assisting with early diagnosis and treatment of health problems
47	00:03:07:00	by including medical, vision, dental, and hearing screenings,
48	00:03:11:13	as well as referrals and treatments,
49	00:03:14:09	by including developmental screenings to include identification, referral,
50	00:03:20:02	and treatment of delays in a child's development,
51	00:03:24:14	by including diagnostic services
52	00:03:27:02	when a screening indicates the need for further follow up.
53	00:03:37:14	This slide goes into more information on what services ABH covers
54	00:03:43:20	and the focus of the EPSDT program.
55	00:03:56:05	So, EPSDT is a key service
56	00:03:58:13	that ensures children and adolescents under age 21
57	00:04:02:17	receive appropriate preventative physical,
58	00:04:06:02	dental, mental health, developmental, and specialty services.
59	00:04:12:16	The overall goal of the program
60	00:04:14:13	is to ensure that individual children and adolescents get the care they need
61	00:04:19:05	when they need it –
62	00:04:21:03	the right care to the right child at the right time in the right setting.
63	00:04:34:05	This slide discusses what ABH does
64	00:04:37:06	to make sure our members are aware of the EPSDT program.
65	00:04:42:17	You might have seen a member handbook.
66	00:04:45:11	These are sent after enrollment in Medicaid,
67	00:04:48:11	and it contains information on EPSDT services.
68	00:04:52:22	Our members also receive text reminders,
69	00:04:57:22	IVR reminders via our outreach campaigns.
70	00:05:02:16	These are sent to the parents or guardians about our healthcare visits that are due.
71	00:05:08:11	Educational materials are also made available.
72	00:05:12:22	These are also mailed to the parents and guardians.
73	00:05:16:11	Our foster care contractors receive gap in care reports
74	00:05:20:22	and these reports provide information regarding when a KBH visit is needed,
75	00:05:26:17	as well as educational materials that are handed out at community events.
76	00:05:34:00	We just participated in the event in Kansas City, Kansas.
77	00:05:38:20	It was the Vibrant Health fair,
78	00:05:41:05	and our table had so many different brochures and pamphlets
79	00:05:45:17	in English and in Spanish,
80	00:05:47:03	and we were able to engage with a lot of our community.
81	00:05:50:11	That was a lot of fun.
82	00:05:59:19	Now, I'll start discussing the individual steps in EPSDT
83	00:06:06:00	The 1st letter E stands for early.
84	00:06:09:20	The earlier conditions are identified, the more successful the treatment.
85	00:06:15:03	Here, we have an example at the bottom of the slide
86	00:06:18:00	where a mom takes her nine-month-old son to the pediatrician for a well visit.
87	00:06:29:08	The second letter stands for periodic.
88	00:06:32:13	Here's where the Bright Futures schedule really comes into play.
89	00:06:36:09	Making sure the parents understand the recommended schedule of visits.
90	00:06:42:08	You may have received access to a patient portal as a parent
91	00:06:46:09	that reminds you of your child's visit.
92	00:06:49:05	You may have also received a pamphlet or a little booklet
93	00:06:52:17	to remind you and keep track of your baby's growth and development.
94	00:06:56:06	Those can all be examples
95	00:06:57:19	of that periodicity schedule that we follow.
96	00:07:08:11	Next letter stands for screening.
97	00:07:11:03	This slide lists the various types of screenings
98	00:07:13:09	that children should receive during the KBH
99	00:07:16:05	as they grow and develop.
100	00:07:18:17	Again, an example of what this screening entails
101	00:07:22:06	can be a mom expressing concern
102	00:07:25:11	that her nine-month-old son isn't sitting up on his own
103	00:07:28:23	during the check up,
104	00:07:29:22	and then the pediatrician will come in and complete a full exam,
105	00:07:34:17	obtain all of that physical history during the appointment.
106	00:07:39:16	Regular screening tests help detect potential health concerns,
107	00:07:45:05	and they include health and developmental history,
108	00:07:48:16	including behavioral health, comprehensive physical exams,
109	00:07:53:08	appropriate immunizations, laboratory testing,
110	00:07:56:22	vision, dental, hearing, and lead screening.
111	00:08:04:14	Now, lead screening receives it's own slide here,
112	00:08:07:11	because it's an important screening test and it's a required component of EPSDT.
113	00:08:13:23	The KBH includes a verbal screening for lead,
114	00:08:17:13	but this does not count as an actual lead screening.
115	00:08:21:22	All that screening must consist of a serum blood test
116	00:08:26:14	and should be completed before the child turns two.
117	00:08:30:11	However, for children older than two who have not previously been screened,
118	00:08:35:17	this test should be completed as soon as possible,
119	00:08:38:22	no matter the age.
120	00:08:48:08	The 4th letter stands for diagnosis.
121	00:08:51:14	Some screenings may identify concerns and additional testing is required.
122	00:08:56:16	The provider should make a referral as soon as the concern is identified
123	00:09:00:20	so that the child can receive treatment if necessary.
124	00:09:05:03	Note the example at the bottom of the slide
125	00:09:08:03	where the pediatrician notes the delays in motor skills
126	00:09:12:00	Let's say were discussing that nine-month-old son
127	00:09:14:08	that the mom brought in,
128	00:09:16:03	the pediatrician will then create a referral
129	00:09:21:06	to see a physical therapist
130	00:09:22:19	that specializes in children's development.
131	00:09:29:23	The final letter, T, stands for treatment.
132	00:09:34:02	Once diagnosed,
133	00:09:35:20	the goal is to have the child receive treatment right away
134	00:09:38:23	so that problems can be corrected.
135	00:09:42:06	Some problems may not be able to be fully corrected,
136	00:09:45:11	but treatment can lessen the severity
137	00:09:47:16	and ensure the child is able to live their fullest life.
138	00:09:54:20	Here, again, is another example
139	00:09:57:14	where the child begins therapy sessions with the physical therapist
140	00:10:01:14	and future visits with the original pediatrician
141	00:10:04:20	will evaluate the progress of those physical therapy visits
142	00:10:09:22	and make further recommendations as needed.
143	00:10:19:17	This slide introduces the terminology "medical necessity."
144	00:10:25:06	Most services are included in the EPSDT benefit,
145	00:10:29:02	but on occasion,
146	00:10:30:13	a provider may recommend a treatment that is not routinely covered,
147	00:10:34:06	but that the provider considers medically necessary.
148	00:10:38:22	The EPSDT benefit can cover these services
149	00:10:42:13	once a medical director on the Aetna team approves the provider's plan
150	00:10:47:14	and agrees with the medical necessity of the service.
151	00:10:51:16	You will see on the slide the three bulleted items
152	00:10:54:20	which, according to Kan Care and Aetna,
153	00:10:57:16	would not be considered medically necessary.
154	00:11:00:17	So, here, we have experimental treatments or items,
155	00:11:04:16	services or items determined to be unsafe or ineffective,
156	00:11:09:13	and services specifically for caregiver convenience.
157	00:11:17:00	Services cannot be denied arbitrarily;
158	00:11:19:16	it will still go through that approval process.
159	00:11:26:06	And a continuation of the discussion on medical necessity,
160	00:11:29:20	states such as Kansas can determine limits
161	00:11:32:19	for any services considered medically necessary,
162	00:11:35:16	and Aetna is required to uphold any limits KanCare stipulates.
163	00:11:48:11	This slide talks about
164	00:11:49:22	the Managed Care Organizations' responsibility
165	00:11:52:23	in determining medical necessity.
166	00:11:56:14	Each case is reviewed by both a nurse and a physician,
167	00:12:00:16	and the guidelines used are national standards.
168	00:12:04:05	The medical director makes the final determination.
169	00:12:07:14	However, providers can appeal these determinations if they desire.
170	00:12:13:05	A side note here,
171	00:12:14:16	the more information provider offices can add to the initial PA form,
172	00:12:19:17	the better.
173	00:12:21:00	In many instances,
174	00:12:22:16	additional information given during the appeal
175	00:12:25:05	is enough to overturn the initial determination.
176	00:12:28:22	In the case of any dispute, the state makes the final determination.
177	00:12:39:13	This slide walks through an example of a child who was diagnosed with ADHD,
178	00:12:44:09	where the mother is seeking respite care services.
179	00:12:48:08	Under the current guidelines,
180	00:12:50:08	respite care is not covered by the EPSDT benefit,
181	00:12:54:09	therefore, this request would be denied.
182	00:13:04:13	So, to recap,
183	00:13:06:16	EPSDT covers children from birth up until they turn 21.
184	00:13:12:11	Children should be receiving annual well-child or KBH visits
185	00:13:17:03	so that their growth and development can be tracked
186	00:13:19:22	and any problems or concerns identified early.
187	00:13:24:06	By staying on track,
188	00:13:26:05	health concerns can be treated early and either corrected or lessened.
189	00:13:32:19	The number at the bottom was the number of children in Kansas
190	00:13:36:06	that would be covered by EPSDT as of August 2022.
191	00:13:52:11	So, I wanted to leave our contact information here.
192	00:13:56:20	We have a Carson Boyd.
193	00:13:58:17	She's our HEDIS quality management manager
194	00:14:01:14	and her email is boydc@aetna.com.
195	00:14:06:02	She can be contacted for any HEDIS-related questions.
196	00:14:09:19	And myself, Tiffany Barrett, I am the EPSDT coordinator here,
197	00:14:14:08	and my email address is barrettt6@aetna.com.
198	00:14:19:11	I can be reached out to for any EPSDT-related question.
199	00:14:31:14	And does anyone have any questions that I may be able to address here?
200	00:14:40:13	We have a little bit of time left.
201	00:14:53:02	Okay. Well, that concludes today's webinar.
202	00:14:56:03	Thank you for joining.
203	00:14:57:17	I will be sending everyone a copy of the slides
204	00:15:00:09	and the participation survey.
205	00:15:02:11	I'll give you your time back. Everyone, have a great day.
206	00:15:08:00	You, too. Thank you.

Trauma-informed care responds to the impact of trauma through recognition and understanding. We take our members’ safety and ability to make their own choices seriously. Want to learn more? Just watch this video about trauma-informed care. Or visit the Center of Excellence for Integrated Health Solutions (CoE) website.