Resources: Quick Guides, Office Forms, Helpful Links

Forms:


NICU/Well-Baby Notification Form

NICU/Well-Baby Notification Form (fillable)

Prior Auth Form

Prior Auth Form (fillable)

Private Duty Services Prior Auth Form

PCP Change Form

PCP Change Form (fillable)

PCP Change Form Spanish

PCP Change Form Spanish (fillable)

Service Area Map

Staff 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.

UHC-MO Resources:


Physical Health Prior Auth Requirements for UHC-MO PCN Members

Physical Health Prior Auth Code Lookup for UHC-MO PCN Members

UHC-KS Resources:


Physical Health Prior Auth Requirements and Prior Auth Code Lookup for UHC-KS PCN Members

HealthyBlue-MO Resources:


Physical Health Prior Auth Requirements for HealthyBlue MO PCN Members

Physical Health Prior Auth Code Lookup for HealthyBlue MO PCN Members

Behavioral Health Prior Auth Requirements and Prior Auth Code Lookup for HealthyBlue MO PCN Members

HealthyBlue-KS Resources:


Physical and Behavioral Health Prior Auth Requirements and Prior Auth Code Lookup for HealthyBlue KS

HealthyBlue Kansas PCN Prior Auth Form

Provider Authorization:


Registration

Electronic Prior Authorization Portal Guide

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

Healthy Blue MO Member Handbook

Healthy Blue KS Member Handbook

Immunization Action Coalition

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

KanCare

Kansas Medical Assistance Program (KMAP)

MO HealthNet for Kids

Northland Medical Managers

UnitedHealthcare Community Plan of Missouri Member Handbook

UnitedHealthcare Community Plan of Kansas 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.

Additional Resources:


Community Resources

EPR-3 Asthma Guidelines

Healthy Habits Assessment

Healthy Habits Assessment - Spanish

NICHQ Healthy Care for Healthy Kids Toolkit


In Partnership with CMH PCN