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Electronic Claims

What are Electronic Claims
Advantages of EDI
Becoming an EDI Trading Partner
Frequently Asked Questions
EDI Forms

Electronic Claims

Frequently Asked Questions

What is the process for enrolling as an EDI provider?

  • Choose a software vendor or billing agency.
  • Contact the EDI helpdesk (800-205-4696) for a Trading Partner ID and password.
  • Ky Medicaid offers a free alternative for low and medium volume providers known as KY HealthNet.

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?

In order to make the weekly payment cycle, your electronic claims file must be submitted\accepted into the system by 3:00 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. A paper image is available through RA Viewer from KY Health Net for business needs. 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.

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 and send to the EDI Helpdesk with a copy of your driver license. You can fax it to 502-209-3200 or email it to KY_EDI_Helpdesk. If you have any questions, please call the EDI Helpdesk at 1-800-205-4696.

EDI Customer Service Survey

The EDI Helpdesk staff strives for Customer Service Excellences; if you experienced customer service excellences at its best or feel improvement is necessary in a particular area please let us know. The survey is for positive or negative feedback, so please take a moment to complete the short survey. The survey is a fillable pdf form which can be emailed to the EDI Helpdesk at KY_EDI_Helpdesk.

Last Updated 5/15/2019 
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