Provider Enrollment

Important Announcement regarding Web Enrollment

Monday, Sept. 22

Effective Sept. 24, 2008, Web enrollment will no longer be available for new submissions. If you submitted your application via the Web prior to Sept. 24, 2008, your enrollment submission will still be processed via the Weband you still will have access to make changes/corrections.

Information regarding National Provider Identifier (NPI)

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) administrative simplification standard the assigns a unique identification number for covered health care providers. Covered health care providers and all health plans and health care clearinghouses will use these NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-digit number that carries no 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 link at left. 

What is a Kentucky Medicaid Provider?

According to KRS 205.8451(7), a Kentucky Medicaid provider is an individual, company, corporation, association, facility or institution providing or 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 providers or entities qualified under 907 KAR 1:671 and 907 KAR 1:672 and approved by DMS to participate. DMS reserves the right to approve or reject a contract with any prospective provider.

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

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

Where do I send my completed forms?

Sent completed, signed forms 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. To request participation as a Passport provider, submit forms to:
Passport Health Plan
305 W. Broadway, 3rd Floor,
Louisville, Ky. 40202
(502) 585-8315

Note: If you are requesting participation as a Doral Dental provider, please contact MaryBeth Crouch at (502) 244-4147 to obtain a dental credentialing packet.

How long will the enrollment process take?

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