Provider Services Branch Contact Information. Toll-Free Phone number:(877)-838-5085Email: Program.Integrity@ky.govHours of Operation:10:00 am-4:30 pmDMS Provider Services Branch Website:http://www.chfs.ky.gov/dms/provEnr/. 2. The Enrollment Process. Determine enrollment requirements at the following:http://www.chfs.ky.gov/dms/provEnr/Provider Types.htmObtain Application and Additional forms at the following :http://www.chfs.ky.gov/dms/provEnr/Forms.htmThe provider completes 29995
Download Policy: Content on the Website is provided to you AS IS for your information and personal use only and may not be sold or licensed nor shared on other sites. SlideServe reserves the right to change this policy at anytime.While downloading, If for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
KY Medicaid Provider Enrollment
August 23, 2010
10:00 am-4:30 pm
P.O. Box 2110
Frankfort, KY 40602
After the individual provider is enrolled, certain changes may occur. In order to keep their provider number current, the appropriate form or documentation must be submitted. Some of the most common changes/updates are the following:
- License Renewals
- Change of Address- Map-529 form
- Change of Name- A signed written request from individual provider requesting name change in addition to a new license and social security card reflecting the new name must be submitted.
- Linkage to group- Map-347 form