Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Gainwell Technologies before sending sensitive documents. FaxFlow is not affiliated with this organization.
Gainwell Technologies fax number
(833) 616-4658
Grievance and Appeals; Prior Authorization (Pharmacy Benefit Management for Ohio Medicaid SPBM)
Used for: Grievance/Appeals submissions and prior authorization inquiries for Ohio Medicaid SPBM; Coordination of Benefits (COB) form submissions
Fax destination details
- Department
- Grievance and Appeals; Prior Authorization (Pharmacy Benefit Management for Ohio Medicaid SPBM)
- Purpose
- Grievance/Appeals submissions and prior authorization inquiries for Ohio Medicaid SPBM; Coordination of Benefits (COB) form submissions
- Form
- COB form — Coordination of Benefits form
- Voice phone
- 1-833-491-0344
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Complete the COB form and submit via email to OH_MCD_PBM_GA@gainwelltechnologies.com or fax to 1-833-616-4658.
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