Kentucky Cabinet for Health and Family Services (Banner Imagery) - Go to home page

Provider Maintenance Information

Kentucky Medicaid is responsible for maintaining complete files for every provider enrolled. These provider files are maintained and updated regularly by the provider services branch.

Please notify Provider Enrollment of any changes to provider name, address, ownership, etc., by contacting:

Kentucky Medicaid
Provider Enrollment
P.O. Box 2110,
Frankfort, KY 40602.

Provider maintenance information forms

Provider Enrollment Updates

Attention Providers

(May 24, 2016) - Please see the updated information below regarding changes to the MAP-347 and the MAP-529.  Please note this change will apply to new submissions of these forms beginning June 1, 2016.

MAP-347, the Statement for Authorization of Payment, Group Linkage Section form has been updated. The old form will be accepted up to 5/31/16. Beginning June 1, 2016, the new MAP-347 will be required. Any MAP-347 submitted after 5/31/16 on the old form will be returned for updating. The distinguishing factor to recognize you are using the correct form is [MAP-347, Rev. 5/16] in the top left corner of the form.

MAP-529, KY Medicaid Change of Information Form has been updated. The old form will be accepted up to 5/31/16. Beginning June 1, 2106, the new MAP-529 will be required. Any MAP-529 submitted after 5/31/16 on the old form will be returned for updating. The distinguishing factor to recognize you are using the correct form is [MAP-529, Rev. 5/16] in the top left corner of the form.

If you have any questions, please either email or call us at 1-877-838-5085.

 

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. - 5:00 p.m. ET
Email: Program.Integrity@ky.gov

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

 

Last Updated 4/26/2017