Centene / Sunflower Health Plan
Welcome to the Centene/Sunflower Health Plan page. Here you can download policies and procedures specific to both ordering providers and imaging facilities. These include quick reference guides and FAQs. You can also view information designed to assist you in using the RadMD Web site to obtain and check authorizations.
If you have any questions about the NIA Program, please contact your dedicated NIA Provider Relations Manager, Leta Genasci.
Update on COVID-19
- Sunflower Health Plan Utilization Matrix (PDF 544K)
- Sunflower Health Plan Ordering Provider Quick Reference Guide (PDF 320K)
- Sunflower Health Plan Rendering Provider Quick Reference Guide (PDF 382K)
- Sunflower Health Plan FAQ (PDF 344K)
- Prior Authorization Checklist (PDF 116K)
- Ordering Provider Access to RadMD (PDF 451K)
- RadMD Quick Start Guide (PDF 450K)
- RadMD Upload Feature (PDF 222K)
- Provider Handbook
- Sunflower Health Plan Provider Resources
Effective June 1, 2020, physical medicine services (physical therapy, occupational therapy and speech therapy) will no longer be managed through a post-service review process. Therefore, beginning June 1, 2020, Sunflower Health Plan will implement a prior authorization of outpatient physical medicine services for its membership.
- Physical Medicine Provider Training PPT (PDF 1,231K)
- Physical Medicine Announcement Letter (PDF 230k)
- Physical Medicine Frequently Asked Questions (PDF 563K)
- Physical Medicine Quick Reference Guide (PDF 242K)
- Physical Medicine Checklist/Tip Sheet (PDF 241K)
Click here to see information about the 2013 Jimmo v. Sebelius settlement involving skilled nursing and skilled therapy services.
- Clinical Guidelines
Refer to the Utilization Review Matrix document to view specific codes managed by NIA