Practitioner and Location Addition

Welcome to WellCare of KY's streamlined, online enrollment process! We are excited that you are considering adding a new practitioner or new location or new facility to your existing contract. Our new user-friendly form is designed to make this process smoother and more efficient for you. By using this form, you will enjoy several benefits, including:

• Increased accuracy: Clear instructions reduce the chance of errors or missing information.
• Quicker turnaround time: Our streamlined approach helps you complete the enrollment faster. By submitting a complete and accurate application, along with the required credentialing documents, you are more likely to achieve a smooth, one-pass enrollment.

• Contractual Status: This form is restricted for adding a practitioner to an existing, contracted group. If the tax ID is not currently contracted with WellCare of KY or Ambetter, please submit a request to Join Our Network. If a request is submitted for a non-contracted group, the request will be returned to you, unprocessed.
• Provider Enrollment Letter: Draft a letter to WellCare of KY on company letter head with details of the specific enrollment request(s).
• Starting Service: No practitioner should begin servicing WellCare of KY members until they have received a Provider Enrollment Confirmation letter from WellCare of KY’s Provider Enrollment department. Our enrollment process can take up to sixty (60) days to complete. We will not backdate effective dates due to services provided ahead of the practitioner’s enrollment.
• CAQH Access: If your practitioner’s specialty requires credentialing, please ensure that CAQH access has been granted to Centene Corporation and that all information has been attested within the last 120 days.
• List of Affiliated Practitioners (LOAP): Please ensure that all headers marked in yellow. Any missing, required information will delay the enrolment and/or credentialing process.
• Specialty Alignment (Medicare and Ambetter): The taxonomy code listed on NPPES must coincide with the specialty requested for enrollment with WellCare of KY and Ambetter.
• Medicaid Eligibility (Medicaid Only): Practitioners who wish to participate in WellCare of KY’s Medicaid product must be enrolled as an active KY Medicaid provider. We must be able to locate the practitioner by their NPI number on the KY state roster.
  • If we are unable to validate your practitioner’s active and compliant enrollment status on the KY state roster, the request will be returned to you, unprocessed.
• For all lines of business: The specialty submitted on the List of Affiliated Practitioners (LOAP) and the "primary specialty" appearing on Page 5 of the practitioner’s CAQH application must match.