Medicaid Provider Information Update

Don’t let outdated contact information cost you. All Medicaid providers must maintain accurate and up-to-date information to prevent payment delays or denials, missed communications and potential disenrollment from Medicaid.

How To Update Your Contact Information

The way you update your contact information depends on your provider type.

Managed Care Organization (MCO) Enrolled Providers

You have two options to update your information:

• Use the online provider enrollment portal.
• Send a letter on your provider letterhead to [email protected]. The letter should clearly detail the changes you need to make.

Fee-for-Service (FFS) ONLY Providers

To update your information, you must submit a File Update Form.

• You can download the form here.
• You can get a form mailed to you by calling Gainwell at 1-877-598-8753.
• The completed form must be signed with an original signature and mailed to:

Gainwell Technologies Provider Enrollment Unit

P.O. Box 80159

Baton Rouge, La. 70898-0159

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 Note: If you are enrolled in both FFS and an MCO, you must follow both processes outlined above to ensure your information is updated with both systems.