This page is accessed through the Public Web Site Provider page. It provides useful information to providers who have completed their enrollment or re-enrollment application through the
Web portal.
Navigation Path: [Provider] - [Provider Matrix]
This page provides information on the
next steps that occur after a provider has submitted their on-line Web portal
enrollment or re-enrollment application. For those providers that
enroll/re-enroll on paper, it also provides a link to the additional
documentation that they must attach to their application.
Please note that each completed document that must be mailed to Gainwell Technologies must
include the Application Tracking Number (ATN), and should be mailed to the
following address:
Gainwell Technologies Provider Enrollment Unit
P.O. Box 5007
Hartford, CT 06102-5007
Please note that providers should not submit to Gainwell Technologies a copy of
the on-line enrollment or re-enrollment application, or complete a paper
application after a Web application has been submitted. Providers should only
submit the required supporting documentation. Without this documentation, Gainwell Technologies cannot process the provider's application.