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Provider Enrollment Applications


Revalidate your existing application online.


Start a new application.


Provider Enrollment Help and Information


Provider Enrollment Wizard Tips

This page is currently under construction.

Effective 3/01/2021, KMAP is no longer
accepting paper applications. Please
refer to bulletin 21008.

Please use the links above to access
the Provider enrollment Wizard.

  • Specific application documents and all other forms are available.
  • To request an EFT form, contact Customer Service at 785-274-5990 or 1-800-933-6593.