MedicaidAdministrativeMedium impact
KMAP BULLETIN: Claims Billing Process for ABH Members with Inpatient Hospital Admissions Prior to 12/31/24 and Discharge after 01/01/25
Kansas Medicaid (KanCare)·KS·Claims & Billing
Effective date
Jan 15, 2025
We identified it
Jun 21, 2026
Summary
New billing process required for Aetna Better Health of Kansas (ABH) members with inpatient hospital stays that began before December 31, 2024 and extend beyond January 15, 2025. Hospitals must submit claims to both Aetna (for prorated payment through 1/15/25) and then to the new MCO (for remaining days after 1/15/25) with specific documentation requirements.
Action Required
For ABH members with inpatient stays crossing 1/15/25: 1) Submit entire claim with itemized statement to primary insurance/Medicare first, then to Aetna. 2) Wait for Aetna's prorated remittance for days through 1/15/25. 3) Submit entire claim with itemized statement AND previous Aetna payment info to new MCO for remaining days. 4) Claims with partial days will be denied - submit complete stay only. Billing team must coordinate dual submissions and track remittances from both payers.