Provider Demographic Updates

Welcome to WellCare of KY's streamlined, online enrollment process! Our new user-friendly form is designed to make demographic updates 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).