Medical billing services in Kentucky
Billing, coding, credentialing and A/R follow-up for providers in Kentucky.
Billing in Kentucky: what is different
Most Kentucky Medicaid members are enrolled in managed care organizations.
Key payers and contractors in Kentucky
- Medicare Part A/B
- CGS Administrators, Jurisdiction J15Portal: myCGS
- Medicare DME
- CGS, DME MAC Jurisdiction BDME supplier claims only · Portal: myCGS
- Medicaid
- Kentucky MedicaidPortal: KYHealth-Net
- Blue Cross Blue Shield
- Anthem Blue Cross and Blue Shield
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with Kentucky providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with CGS Administrators through myCGS
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in Kentucky: common questions
Do you bill Kentucky Medicaid and its managed care plans?
Yes. We bill Kentucky Medicaid fee-for-service claims and each Medicaid managed care plan, after confirming the patient’s assigned plan for the date of service.
Who processes Medicare claims in Kentucky?
Medicare Part A and B claims in Kentucky are processed by CGS Administrators (Jurisdiction J15), and we submit and track them through myCGS. DME supplier claims go to a different contractor, CGS (DME MAC Jurisdiction B), through myCGS.
Can you credential new providers in Kentucky?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Kentucky.
Neighboring states and key payers
Get a free billing audit for your Kentucky practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.