Payment Process and Provider Billing Forms

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The DCC-97, Provider Billing Forms (PBF) are available on the first day of each month to cover the prior month’s CCAP enrollments. 

Providers who use the KICCS Provider Portal can access and submit their billing electronically.

Providers who do not use the Provider Portal will receive their paper PBF in the mail.

Paper PBFs are mailed out on the first business day of each month.  Paper PBFs may be returned to DCC via email at CCAPProviderPayments@ky.gov, mailed using the address on the form, or faxed to 502-564-3464.

Once in the New PBF status, a PBF will remain open for submission for 90 days. 

After 90 days the PBF will void, and payments will not be processed.  

The KICCS User Guide Print a PBF’s Guide can help answer questions you might have about the PBF.

KICCS Provider Portal Launch Site