Effective July 17, 2017, MCO-only providers may enroll on the Provider Enrollment Application (PEA) portal. There are links available on the portal for in-state and out-of-state providers. For assistance with your application, please contact the Gainwell Technologies Provider Enrollment department at 1-888-483-0793.
Once your enrollment application has been submitted through the Gainwell Tehcnologies PEA Portal, a letter will be mailed to the Pay To provider’s mailing address if any correction or missing documentation is required. Providers will then have 60 days from submission of the application to submit corrections or missing documents to the Gainwell Technologies Provider Enrollment department. All signature pages from the application must be mailed to Gainwell Technologies, signed in BLUE ink. Upon completion of your enrollment, each Pay To provider will receive a welcome letter from Gainwell Technologies and the MCO will be notified.
Providers will have 120 days from the date of enrollment to complete their enrollment application via the Gainwell Technologies PEA portal. MCO providers who are already enrolled with WV Medicaid do not need to submit a separate enrollment application.