Electronic Claims

Electronic Claims

Frequently Asked Questions

What is the process for enrolling as an EDI provider?

• Choose a software vendor or billing agency. You may obtain a list of these from the EDI helpdesk at: (800)205-4696. We also offers a Direct Data Entry process (Ky HealthNet) free of charge for low and medium volume providers.
• Contact the EDI helpdesk (800-205-4696) for a Trading Partner ID and password.
• Submit an EDI test.

Where do I get a Trading Partner ID and Password?

You may call the Electronic Claims helpdesk toll free at 800-205-4696. This area will be happy to assist you with any questions you may have regarding electronic claims submission. The helpdesk will take your calls Monday through Friday between the hours of 7:00 am and 6:00 pm, EST.

What are the testing requirements?

Click here for a comprehensive list of testing requirements.

Once I submit and electronic file, how long is it before I receive payment?

The usual timeframe is approximately 21 days once your claims are submitted. In order to make the weekly payment cycle, your electronic claims file must be submitted\accepted into the system by 5:00 EST each Friday.

Can I get my Remittance Advice (RA) electronically?

We offer electronic RA's in the 835 X12 format. If you are interested in retrieving your remittance advice in the 835 format you will need to contact the EDI Department at (800)205-4696. We will continue to send you a paper remittance advice for tax purposes or additional bookkeeping needs, unless a request is made to no longer recieve paper copies. Click here for the 835 Request Form.

What is Ky HealthNet?

KY Health Net is a web-based system designed to allow Medicaid Provider instant access to pertinent member information, claim inquiry, PA inquiry, RA viewer and claim submission. A user manual is available for downloading and is designed to assist you in navigating through the system. If at any time you have questions please contact the EDI Helpdesk at 800-205-4696 or by email at KY_EDI_Helpdesk@hp.com.

Please keep in mind the information contained on the KY health Net system is highly confidential and access should be strictly limited to those with valid reasons. It is the responsibility of the provider and the system administrator to ensure all persons with access understand the appropriate use of this data. We highly recommend the creation and implementation of guidelines within your office outlining appropriate and inappropriate uses of this data.

To create a KY Health Net account please complete the Pin Release form to the EDI Helpdesk along with a copy of your driver license to fax 502-209-3242 or 502-209-3240 attention: EDI Helpdesk. For questions about the Pin Release form contact the EDI Helpdesk at 800-205-4696 or KY_EDI_Helpdesk@hp.com.