DSH Application - indigent care eligibility form to assess a patient's financial situation to determine if the patient meets the DSH guidelines.
Disproportionate Share Hospital Program (DSH) is a program of hospital care for Kentucky's indigent citizenry provided by Kentucky hospitals participating in the Kentucky Medicaid Program. Prior to billing a patient and prior to submitting the cost of the hospital service to Medicaid as uncompensated, a hospital uses the
Patient eligibility requirements
- The patient must be a Kentucky resident.
- Resources (financial and other) belonging to the patient and the patient's family are taken into consideration during the determination.
- The patient cannot have any other medical insurance coverage, including private insurance, any type of government-funded coverage, KCHIP, or be eligible for Medicaid.
Provider Contact Information
- For billing questions, contact DXC at (800) 807-1232 or visit the
- For provider questions, contact the
Provider Services Call Center at
(855) 824 5615
- For provider enrollment or revalidation questions, contact
Provider Enrollment at (877) 838-5085
- For KyHealth-net assistance, email DXC
- To report fraud and abuse, contact
Fraud Hotline at