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- 2021 RA Banner Announcements Archived
Banner Effective DateProvidersBanner Page Announcement
03/26/2021-04/02/2021Attention PCMH Primary Care ProvidersAttention PCMH Primary Care Providers. REPROCESSED THIS CYCLE: Primary Care Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or end dated from the PCMH program. Claims which processed prior to the completion of the provider's PCMH enrollment were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For those providers retroactively end dated, claims were paid with the PCMH differential payment rate that have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your March 30, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/26/2021-04/02/2021Attention Primary Care ProvidersAttention Primary Care Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims for providers who were retroactively approved for the HUSKY Health Primary Care Increased Payments policy. The impacted claims have been reprocessed and will appear on your March 30, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52.
03/26/2021-04/02/2021Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your March 30, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/26/2021-04/02/2021Attention Pharmacy ProvidersAttention Pharmacy Providers. REPROCESSED: The Department of Social Services (DSS) has conducted a comprehensive review of all paid pharmacy claims submitted to the Connecticut Medical Assistance Program (CMAP) with a diagnosis code of I27.0, I27.2, I27.20, I27.21, I27.23, I27.24, I27.29, I27.89, I73.00, I73.01, J84.112, Q82.0, K22.4, T70.20XA, T70.20XD, T70.20XS, T70.29XA, T70.29XD, T70.29XS, N40.0, N40.1, N40.2 and N40.3 or applicable ICD-10 codes, for paid dates from January 1, 2017 to December 31, 2019. It has been determined that claims were billed improperly using the diagnosis codes noted above. The result of this review indicates that these claims were used for the treatment of erectile dysfunction (ED), which is not payable by DSS. These claims have been recouped and will appear on the March 30, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with the region code 52.
03/12/2021-03/19/2021Attention Select Skilled Nursing FacilitiesAttention Select Skilled Nursing Facilities. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the March 12, 2021 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your March 16, 2021 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
03/12/2021-03/19/2021Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the March 16, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefits (EOB) code 8239 "ACA CLIENT TEMP ID REPLACED WITH CMAP ID. NEW CLAIM WILL BE SYSTEMATICALLY GENERATED". The new claims will also appear on the March 16, 2021 RA with an ICN beginning with region code 27.
03/12/2021-03/19/2021Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially paid and posted one of the following informational Ordering, Prescribing, Referring (OPR) Explanation of Benefit (EOB) codes, but for which the provider in question has since successfully enrolled in the Connecticut Medical Assistance Program (CMAP): - "EOB Code 0237-PRESCRIBING PROVIDER IS A STUDENT OR RESIDENT AND MUST BE ENROLLED TO PRESCRIBE" - "EOB Code 0027-CLAIM BYPASSED EDIT 0207 DUE TO PPE AUTO-PA" - "EOB Code 0207-PRESCRIBER NOT ENROLLED " - "EOB Code 0028-PRESCRIBING PROVIDER IN PROCESS OF ENROLLING" - "EOB Code 1040-ORDERING/REFERRING/ATTENDING PROVIDER IS NOT ENROLLED ON DATE OF SERVICE" These claims will appear on the March 16, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
03/12/2021-03/19/2021Attention Select Home Health AgenciesAttention Select Home Health Agencies. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the March 12, 2021 claims cycle. The recoupments are related to a Home Health Agency settlement with CMS and will appear on your March 16, 2021 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
03/12/2021-03/19/2021Attention Select Outpatient HospitalsAttention Select Outpatient Hospitals. REPROCESSED THIS CYCLE: The Department of Social Services (DSS) updated the Connecticut Medical Assistance Program (CMAP) Addendum B to incorporate Ambulatory Payment Classification (APC) weight changes for dates of service January 1, 2021 and forward on February 10, 2021. Gainwell Technologies has identified and reprocessed any claims with a retroactive APC weight change for dates of service January 1, 2021 and forward. The reprocessed claims will appear on the March 16, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 50.
03/12/2021-03/19/2021Attention Inpatient HospitalsAttention Inpatient Hospitals. REPROCESSED THIS CYCLE: Gainwell Technologies had identified an issue with inpatient claims processed between January 27, 2021 and February 3, 2021 that were missing the Diagnostic Related Group (DRG) code on the claim. Gainwell Technologies has corrected the issue and the identified claims were adjusted and will appear on the March 16, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 15, 27, or 52.
03/12/2021-03/19/2021Attention Outpatient HospitalsAttention Outpatient Hospitals. REPROCESSED THIS CYCLE: The Department of Social Services (DSS) updated the Connecticut Medical Assistance Program (CMAP) Addendum B to incorporate the 2021 Healthcare Common Procedure Coding System (HCPCS) changes for dates of service January 1, 2021 and forward on February 10, 2021. Gainwell Technologies has identified and reprocessed any claims with new procedure codes that were processed prior to February 10, 2021. The reprocessed claims will appear on the March 16, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 and 61.
02/19/2021-02/26/2021Attention All ProvidersAttention New Providers. NEW PROVIDER WORKSHOP: Newly enrolled providers or new business office staff are invited to register for and attend the New Provider Workshop Virtual Room to be held on Friday, February 26, 2021. Additional information and the registration link can be found on the CMAP Web site, www.ctdssmap.com. Please select Provider Training in the Provider Quick Links box, then New Provider Workshop Invitation.
02/19/2021-02/26/2021Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your February 23rd, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
02/05/2021-02/12/2021Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the February 9, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefits (EOB) code 8239 "ACA CLIENT TEMP ID REPLACED WITH CMAP ID. NEW CLAIM WILL BE SYSTEMATICALLY GENERATED". The new claims will also appear on the February 9, 2021 RA with an ICN beginning with region code 27.
02/05/2021-02/12/2021Attention All ProvidersAttention All Providers. 2020 1099S AVAILABLE FOR DOWNLOAD FROM WEB SITE: The 1099s for year 2020 are now available for download from the www.ctdssmap.com Web site. The functionality to download 1099s is available for all Master Users and any subordinate clerk accounts who have access to download PDF Remittance Advice files. The 2020 1099s were also mailed via the USPS to providers on January 27, 2021. Providers wishing to download their 2020 1099 from www.ctdssmap.com would do so by logging into their secure Web portal account, selecting Trade Files then download. Providers must then click on the 1099s selection located at the top of the drop-down menu. Users would then scroll down and select the 2020 1099 from the "Current Files Available for Download" panel. The retention period for 1099s on the secure Web portal account is three (3) years. Providers are encouraged to download and save a local copy of the 1099s as, after three (3) years, the downloadable files will be removed and no longer available.
01/22/2021-01/29/2021Attention Select Skilled Nursing FacilitiesAttention Select Skilled Nursing Facilities. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the January 22, 2021 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your January 26, 2021 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
01/22/2021-01/29/2021Attention Select Skilled Nursing FacilitiesAttention Select Skilled Nursing Facilities. PAYOUT TRANSACTIONS: The Department of Social Services (DSS) completed recoupments related to a Skilled Nursing Facility settlement with Centers for Medicare & Medicaid Services (CMS) in the November 20, 2020 financial cycle. The transaction incorrectly recouped more money than the settlement amount. DSS completed a financial payout to refund the excess money that was recouped in the November 20, 2020 financial cycle. The payout will appear on your January 26, 2021 Remittance Advice (RA) under Financial Payout with reason code 8306 "Payment Appeals".
01/22/2021-01/29/2021Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your January 26, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
01/08/2021-01/15/2021Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the January 12, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefits (EOB) code 8239 "ACA CLIENT TEMP ID REPLACED WITH CMAP ID. NEW CLAIM WILL BE SYSTEMATICALLY GENERATED". The new claims will also appear on the January 12, 2021 RA with an ICN beginning with region code 27.
  
+ 2020 RA Banner Announcements Archived
  
+ 2019 RA Banner Announcements Archived
  
+ 2018 RA Banner Announcements Archived
  
+ 2017 RA Banner Announcements Archived
  
+ 2016 RA Banner Announcements Archived
  
+ 2015 RA Banner Announcements Archived
  
+ 2014 RA Banner Announcements Archived
  
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