Call the Interactive Voice Response (IVR) to Verify Eligibility  

Mar 01, 2024

You can call Gainwell Provider Services’ Interactive Voice Response (IVR) phone line to verify member eligibility for pharmacy claims. You will need your pharmacy’s National Provider Identify (NPI) and the member’s MaineCare ID number. Call 1-866-690-5585 and press or say the number 1. The automated system will prompt you through the call. The system will respond best when responses are keyed into the keypad instead of announced verbally. 

 Instructions 

1. Call 1-866-690-5585. 

2. Select or say 1. 

3. Enter the NPI. 

4. Select 1 to enter the Mainecare ID number and follow the remaining prompts.   

OR 

Select 2 for entering the date of birth and social security number and follow the remaining prompts.  

You can select 0 at any time to talk to a live Gainwell Provider Services representative.