Insurance Payer Portals & Essential Websites
- 15 hours ago
- 2 min read
Managing payer enrollment, credentialing, billing, and prior authorizations requires access to multiple provider systems. Below is a consolidated list of commonly used portals and resources for behavioral health providers in Kentucky.
TriCare East
Used for:
Provider enrollment and account management
Claims and eligibility
Authorizations
Patient benefit verification
Medicare
Required to:
Create and manage Medicare access credentials
Access PECOS
Manage delegated users
Used for:
Medicare provider enrollment
Revalidations
Updating provider information
Kentucky Medicaid
Used for:
Medicaid enrollment and revalidation
Claims and eligibility
Prior authorization tracking
Provider maintenance updates
Medicaid revalidation is required every 5 years to maintain enrollment status.
Alcohol and Other Drug Entity (AODE) Licensure
Used for:
Accessing and managing AODE licensure
Submitting licensure applications and updates
Managing Kentucky state entity access and authentication
Accessing CHFS-connected systems and applications
Availity
Common functions include:
Anthem provider enrollment support
Eligibility and benefits verification
Claim status searches
Secure payer messaging and chat
Humana EFT/ERA enrollment
United Healthcare
Used for:
Behavioral health claims
Authorizations
Eligibility verification
Network participation information
Used for:
EFT enrollment
Remittance and payment tracking
Payment reconciliation
WellCare of Kentucky
Used for:
EFT enrollment
ERA enrollment
Payment management
Used for:
Claims
Authorizations
Eligibility checks
Provider communications
Prior Authorization Updates
Humana
Passport by Molina
United Healthcare Community Plan Kentucky
Helpful Provider Resources
Centralized provider credentialing database used by all insurance payers. Required for credentialing.
National database used to verify NPI information.
License verification and professional licensing information.
Verify Kentucky social work licensure status and information.
Clinical and Medicaid Resources
Used to:
Verify Medicaid coverage
Access recipient eligibility information
Review Medicaid billing resources
Clinical portal providing:
Real-time and historical patient data
Access to information from multiple healthcare systems
Medicaid recipient clinical data integration