DialClerk Directory

Ohio Medicaid (ODM)

Pharmacy and drug authorizations

Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.

pharmacy help desk

Ohio Medicaid single pharmacy benefit manager (Gainwell SPBM) help desk and pharmacy prior authorization

Official page read
Phone833-491-0344TTY phone833-655-2437Fax

833-679-5491

Pharmacy prior authorization fax

Published email

OH_MCD_PBM@gainwelltechnologies.com

Published hours

Technical help desk 24 hours daily; clinical PA desk Mon-Fri 8am-8pm ET (closed Thanksgiving and Christmas)

Product, plan and location

medicaid
Ohio

Mailing address
Gainwell Technologies OH SPBM P.O. Box 3908 Dublin, OH 43016-0472

Gainwell SPBM correspondence and grievances/appeals

Gainwell OH SPBM (2023 ODM-hosted pharmacy reference guide v2.0). Gainwell is the SPBM for all Ohio Medicaid managed care (except MyCare) and fee-for-service pharmacy: claims processing, technical issues, PA inquiries and overrides. Pharmacy claims: BIN 024251; PCN OHRXPFFS (FFS) or OHRXPROD (managed care). Portal: spbm.medicaid.ohio.gov. Not for physician-administered drugs billed on the medical benefit (MCO handles).

View source ↗ · Source checked 2026-10-25 · ODM SPBM FFS provider FAQ: call center number and TTY ↗ · CareSource Ohio manual: Gainwell SPBM phone, fax and P.O. Box ↗

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

pharmacy help desk

Ohio Medicaid OAAC pharmacy rate review help desk (Myers and Stauffer PPAC)

Official page read
Phone800-591-1183Published email

OHPharmacy@mslc.com

Published hours

Not published in this record

Product, plan and location

medicaid
Ohio

Mailing address

Not researched for this route

Initial OAAC (Ohio Average Acquisition Cost) rate reviews for pharmacies; appeals then go to MedicaidSPBM@medicaid.ohio.gov.

View source ↗ · Source checked 2026-10-25

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

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Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.

Have ready in your secure workspace

  • PBM name and the pharmacy identifiers on the card
  • Drug, formulation and prescription information
  • Prescriber details and previous review reference

Questions to resolve

  • Is this processed under the medical or pharmacy benefit?
  • What is the correct review and submission channel?
  • Is there a separate specialty pharmacy or appeal team?

This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.

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