Web12 hours ago · N3 Subscriber Address Required; Recipient Address details N4 Subscriber City, State, Zip Code Required; Recipient City, State, Zip code DMG Subscriber Demographic ... mail to: Gainwell Technologies PO Box 23076 Jackson, MS 39225 PWK05 Identification Code Qualifier Number WebIt is the responsibility of the Medicaid provider to keep all provider information current and accurate on the Louisiana Medical Assistance Program provider files. Providers must always notify Gainwell Technologies Provider Enrollment when a mailing or service address and phone number change occurs. This ensures that rejected claims and ...

IHCP Quick Reference Guide Contact Information

WebGainwell must have a copy of your current license. If you have not sent, or any time your license is renewed, please mail a copy of your current license and W-9 to: ... Member Services Mailing Address. PO Box 2002, Charleston WV 25327-2002 Provider Relations, Member Services PO Box 625, Charleston WV 25322-0625 Enrollment & EDI Help Desk ... WebAll paper claims and documentation should be mailed to: Gainwell Technologies PO Box 2010 Warwick, RI 02887-2010 Reminder: CMS 1500 Version 02/12 is required after April … spc sehati

Third Party Liability and Recovery Office of the Medicaid …

WebBusiness Name Mailing Address Street 1 Mailing Address Street 2 City State ZIP Code ZIP +4 Phone Number 0001193500 AMERICAN GENERAL LIFE & ACCIDENT PO BOX 1500 NASHVILLE TN 37202 8008881038 1030586026 AMERICAN HEALTHCARE ALLIANCE PO BOX 8530 KANSAS CITY MO 64114 8008706252 0001026700 … http://www.vtmedicaid.com/assets/manuals/GeneralProviderManual.pdf WebProvider Contacts Colorado Department of Health Care Policy & Financing Home For Our Providers Provider Services Provider Contacts Provider Contacts 2024 Holiday Schedule … spcs certified applicator licensing