Provider Enrollment

Information regarding National Provider Identifier (NPI)

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard.  The NPI is a unique identification number for covered health care providers.  Covered health care providers and all health plans and health care clearinghouses will use the NPIs in the administrative and financial transactions adopted under HIPAA.  The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty.

For instructions on obtaining an NPI, refer to the DMS National Provider Identifier (NPI) page located on the left. 

What is a Kentucky Medicaid Provider?

According to KRS 205.8451(7), a Kentucky Medicaid Provider means an individual, company, corporation, association, facility or institution which is providing or has been approved to provide medical services, goods or assistance to members under the Medical Assistance Program.

How do I qualify and where do I apply?

The Department for Medicaid Services (DMS) only contracts with those providers or entities who can demonstrate that they are qualified in accordance with 907 KAR 1:671 and 907 KAR 1:672 as determined by DMS to participate as a provider.  DMS reserves the right to contract or not contract with any potential provider.

All entities wishing to participate must be enrolled as participating providers prior to being eligible to receive reimbursement in accordance with federal and state laws.  Enrollment in the program is not guaranteed.  Therefore, providing services to Kentucky Medicaid members prior to your effective date is at your own financial risk.

Provider Enrollment information and forms can be found at the KyHealth Choices Web site.

Where do I send my completed forms?

All completed and signed forms must be returned to;
KyHealth Choices
Provider Enrollment
P.O. Box 2110
Frankfort, KY 40602.

Note: For more information on Passport, see the Passport Health Plan information on the right.  If you are requesting participation as a Passport provider, submit the forms to:
Passport Health Plan
305 W. Broadway, 3rd Floor,
Louisville, KY 40202.
502-585-8315

How long will the enrollment process take?

The enrollment process can take up to 90 days to complete, assuming you have submitted all the necessary forms and information/verification required.  If there are any outstanding accounts receivable, you will need to satisfy those debts before the application can be approved.