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Frequently Asked Questions

Q1. How long will it take to get a provider number?
It generally takes 60 to 90 days from receipt of a correct application.

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Q2. What happens if my application is returned for corrections?
The enrollment process must begin again if errors are made on the enrollment application. It will take another 60 to 90 days to receive a provider number. Please review the application for completeness or missing documentation before submitting it.

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Q3. What can I do to make sure my application is processed as quickly as possible?
Be sure your application is complete and accurate. Do not omit any information requested and provide a response in each form field. Even if something requested does not apply, please write in "N/A." Be sure all required provider type documentation is attached. If enrolling an individual provider (e.g. physician, dentist, nurse practitioner, etc), attach the enrollee's license and Social Security card. If enrolling a group, attach IRS documentation and any documents that pertain to that group.

If you have problems with the application, contact your MCO program or a provider services representative at (877) 838-5085. Representatives can answer your questions about the application over the phone to help you complete your application correctly. To verify which forms you need, refer to the Provider Type Summaries.

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Q4. Is there an example of a completed MAP 811 ? Yes, please view the example of a completed, paper MAP-811 Individual and a MAP-811 Non-Credentialed Provider sample application.

Please note: The sample applications is provided for information and reference only. Your application should reflect your individual or group information to ensure accuracy.

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Q5. Can I fax maintenance documentation, such as licenses, change of address forms, etc to DMS? No, since all documentation must be imaged prior to being processed, all mail must be sent to HP. Please see Q8 below.

Faxing documentation to DMS will not only delay the processing, but this could also cause the documentation to not get processed at all.

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Q6. Where do I send my application to?
You will send the application to the MCO of your choice. Please refer to the Managed Care Organization Information tab on our website or contact the MCO of your choice directly at the phone numbers listed below.

  • Anthem - 800-205-5870
  • Coventry - 855-300-5528
  • Humana Caresource - 855-852-7005
  • Passport - 800-578-0775
  • Wellcare - 877-389-9457

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Q7. Who do I call to check the status of my application?
You can contact the MCO program in which you submitted the application to or you may contact provider services at KY Medicaid at 1-877-838-5085.

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Q8. Where do I send my correspondence or maintenance documents such as license, change of information form, etc... to?
If you wish to send any documentation to update your files or maintain your files, such as a MAP-529 (change of information form), license, etc.,

Please mail the document to:
Provider Enrollment
PO Box 2110
Frankfort, KY, 40602

If you wish to send the document to a physical address, please mail to:
HP
Attn: Provider Enrollment
656 Chamberlin Drive
Frankfort, KY 40601

Do not mail any documents or applications directly to DMS. Mailing to DMS will not only delay the processing time, but there is no guarantee the document will be delivered to the correct area for processing. Please write your KY Medicaid provider ID number on each document before submitting the document.

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Q9. How will I be notified once my application is completed/processed?
Once a final decision has been made, KY Medicaid will notify you via email, fax or mail.

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Q10. If I am an individual provider who is changing practice locations, who do I need to notify of this change?
Note
: For any MCO's you are enrolled with, you may need to contact them of the change as well.

First, refer to our provider type summaries page. If you are an individual provider who requires to be enrolled in Medicare primary, please complete a MAP-529 - Kentucky Medicaid Change Information Form and attach verification from Medicare, if applicable, of the address change with Medicare. If you are changing location to a different state, please attach a copy of the license for the state you will be practicing in with the MAP-529 form.

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Q11. If I am an entity provider who would like to add additional locations, what do I need to submit to KY Medicaid?
Note: For any MCO's you are enrolled with, you may need to contact them of the change as well.

First, please refer to our Provider Type Summaries page. If you are an entity who requires to be licensed (such as a hospital, independent Laboratory, etc.,) you will need to enroll each location separately. Or if you are an entity such as a physician group that is opening additional locations in the same state, and you have a CLIA certificate, you must enroll each location separately. If you are an entity in different states, each state would have to enroll separately whether there is a CLIA certificate involved or not.

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Q12. If I cannot locate my KY Medicaid provider number, how can I get my number released to me?

  • If you are an individual provider , submit a written request, signed by you the individual provider, on letterhead along with your Social Security Number, NPI# and your signature. If you would like the request be emailed to you, please provide an email on the request. If you would prefer the request be faxed to you, provide that information on the request as well, and mail the request to:
    KY Medicaid
    P.O.Box 2110
    Frankfort, KY 40602
  • If you are an entity and would like the KY Medicaid provider number sent to you, please submit a written request with your FEIN number, NPI number, and physical location on company letterhead. The letter must be signed by an owner, officer or board member along with their title. Submit the request to:
    KY Medicaid
    P.O. Box 2110
    Frankfort, KY 40602

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Contact Information
 

Kentucky Department for Medicaid Services
Provider Enrollment
P.O. Box 2110
Frankfort, KY 40602
Toll free: (877) 838-5085
Monday to Friday
8 a.m. - 4:30 p.m. ET
Email: Program.Integrity@ky.gov

For other questions or assistance, e-mail the CHFS DMS Webmaster

 

Last Updated 1/16/2014
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