Providers submitting reconsideration requests to Gainwell Technologies should use the new form that is now located on the Vermont Medicaid website (http://www.vtmedicaid.com/#/forms). This form is to be used for non-timely filing reconsideration requests only; there is a separate form for timely filing reconsideration requests. Effective 4/25/2022, old versions of the Reconsideration Request Form will no longer be accepted and will be returned to the provider.
Updated Reconsider Request Forms
