Managed Care Organization

How to Get Credentialed with Anthem HealthKeepers / Hoosier Healthwise in Kentucky

Network: Open
CAQH Required

Quick Overview

Timeline

Varies

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

Kentucky-Specific Requirements

Anthem BCBS of Kentucky participates in the Kentucky Medicaid managed care program. Providers must first enroll with Kentucky Medicaid through DMS, then apply to Anthem via CAQH ProView. Active Kentucky medical license and NPI are required. Service areas cover all 120 Kentucky counties. The plan serves traditional Medicaid, KCHIP, and Medicaid expansion populations across the state.

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Kentucky.

2

Complete Your CAQH ProView Profile

Anthem HealthKeepers / Hoosier Healthwise requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.

3

Submit Your Application

Submit your completed enrollment package to Anthem HealthKeepers / Hoosier Healthwise.

4

Track & Follow Up

Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

Board Certification

Conditional

Required if board certified; highly recommended

CV/Resume

DEA License

Conditional

Required if prescribing controlled substances

Malpractice Insurance

Medical Degree

Medical License

NPI Certificate

Professional Reference

Contact Information

Credentialing

National

Network Enrollment

National

Quick Links

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