MAP-811 Provider Application Instructions - KYMMIS
Revised 2/2004 MAP-811 Application Instructions 1 MAP-811 Provider Application Instructions Enrollment Block: • If applying for a Kentucky Medicaid number for the first time, check first block.
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COMMONWEALTH OF KENTUCKY Cabinet for …
www.kymmis.comPRIOR AUTHORIZATION FOR HEALTH-SERVICES 1. Medicaid I.D. No. 2. Recipient Last Name: 3. First Name: 4. M.I. Ten Digits
ORP Frequently Asked Questions (FAQs) - KYMMIS
www.kymmis.comORP Frequently Asked Questions (FAQs) 1. Why is Kentucky Medicaid requiring Ordering, Referring, and Prescribing Providers (ORP Providers) to enroll as Kentucky Medicaid providers?
KyHealth Choices PIN Release Form - KYMMIS
www.kymmis.comKyHealth Choices PIN Release Form Fax Complete Form and Copy of Valid Driver’s License To: 502-209-3242 Or email to the EDI Helpdesk at KY_EDI_Helpdesk@hpe.com
Map 130 PRIOR AUTHORIZATION FAX-FORM (Rev. 09/11) …
www.kymmis.comPRIOR AUTHORIZATION FAX-FORM Kentucky Medicaid Home Health Services Program FAX NUMBER: 1-800-664-5749 CALL IN: 1-800-664-5725 Page 1 Map 130
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