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- 2019 Important Messages Archived
Message Effective DateTitle
12/03/2019-12/03/2019

Attention Providers: Delayed Opening Notification (Posted 12/3/19)
10/23/2019-11/12/2019

DRG Calculator Updated (Posted 10/23/19)
10/22/2019-11/12/2019

CMAP Addendum B October 2019 (Updated 10/22/19)
10/20/2019-10/20/2019

Attention All Providers: Service Interruption Notification (Posted 10/21/19)
10/18/2019-12/03/2019

Attention Prescriber and Pharmacy Providers: Temporary Suspension of Diagnosis Code Requirement for Opioid Medication Claims Notification (Posted 10/18/19)
10/10/2019-11/12/2019

Hospital Monthly Important Message (Updated 10/10/19)
10/10/2019-11/30/2019

Attention Providers: Provider Bulletin 2019-60 Re-issued (Updated 10/11/19)
09/24/2019-10/23/2019

Attention: Non-Medical Mental Health Waiver Services Providers (Posted 9/24/19)
09/17/2019-10/18/2019

Attention DME Providers: Update Regarding New Ordering/Referring/Rendering Edits (Posted 9/18/19)
09/17/2019-10/10/2019

Trauma Questionnaire Fax Number (Posted 9/17/19)
09/15/2019-11/15/2019

ATTENTION BIRTH TO THREE PROVIDERS: Assessment Units Increase (Posted 9/16/19)
09/12/2019-10/01/2019

Attention Dental Providers: Discontinue Billing Code D2990 (Posted 9/12/19)
09/09/2019-10/07/2019

Hospital Monthly Important Message (Updated 9/10/19)
09/04/2019-10/01/2019

Revised Provider Manual Chapters (Updated 9/4/19)
08/26/2019-09/23/2019

Attention: Non-Medical Mental Health Waiver Services Providers (Posted 8/26/19)
08/15/2019-09/30/2019

Non-Medical Mental Health Waiver Enrollment Reminder (Posted 8/15/19)
08/14/2019-09/09/2019

Hospital Monthly Important Message (Updated 8/14/19)
08/08/2019-09/03/2019

Revised Provider Manual Chapters (Updated 8/8/19)
08/06/2019-08/07/2019

Attention All Providers: Service Interruption Resolution Notification (Updated 8/7/19)
07/31/2019-09/30/2019

Attention Primary Care Providers: Upcoming CME Conference (Posted 7/31/19)
07/24/2019-10/21/2019

CMAP Addendum B July 2019 (Posted 7/24/19)
07/24/2019-08/31/2019

Attention: Electronic Visit Verification (EVV) Service Providers Shared Prior Authorization (PA) Issue (Posted 7/24/19)
07/23/2019-08/31/2019

Discontinue Billing Select Pricing Modifiers when Billing for Evaluations Performed (Posted 7/23/19)
07/22/2019-07/23/2019

Attention: Electronic Visit Verification (EVV) Service Providers Shared Prior Authorization (PA) Issue (Posted 7/22/19)
07/17/2019-08/17/2019

Attention All Providers: Upcoming AVRS Menu Option Change (Posted 7/18/19)
07/15/2019-07/23/2019

CMAP Addendum B July 2019 (Posted 7/16/19)
07/11/2019-08/13/2019

Hospital Monthly Important Message (Updated 7/12/19)
06/25/2019-06/28/2019

Attention Providers: EFT and ASC X12 835 Health Care Claim Payment/Advice Delay (Posted 6/25/19)
06/24/2019-06/25/2019

Corrected 2018 1099-Misc Forms Notification
06/18/2019-07/11/2019

Hospital Monthly Important Message (Updated 6/19/19)
06/17/2019-07/12/2019

Attention Primary Care Providers (Updated 6/17/19)
06/10/2019-06/11/2019

Electronic Visit Verification Implementation Important Message (Updated 6/12/19)
06/07/2019-06/08/2019

Attention All Providers: Call Center Outage Resolved (Updated 6/7/19)
06/06/2019-06/06/2019

Attention All Providers: Call Center Outage (Posted 6/7/19)
05/29/2019-07/10/2019

Attention Ambulatory Surgical Center Providers: Claim Denial Issue (Updated 5/30/19)
05/28/2019-06/12/2019

Attention Long Term Care Providers: Applied Income (AI) Issue (Updated 5/28/19)
05/20/2019-07/31/2019

Attention All Providers: Requirements Around Non-Emergency Medical Transportation (NEMT) Transports to the Closest Provider (Posted 5/20/19)
05/14/2019-06/18/2019

Hospital Monthly Important Message (Posted 5/14/19)
05/14/2019-05/24/2019

Attention Long Term Care Providers: Applied Income (AI) Issue (Posted 5/14/19)
05/10/2019-08/01/2019

Attention Ophthalmology Providers: Billing Guidance Concerning Off-label Use of Avastin (Bevacizumab) (Updated 5/10/19)
05/10/2019-05/14/2019

Attention: Electronic Visit Verification (EVV) Service Providers - Intermittent Telephony Outage (Updated 5/10/19)
05/09/2019-05/14/2019

Attention: Electronic Visit Verification (EVV) Service Providers Intermittent Telephony Outage (Posted 5/9/19)
05/03/2019-06/02/2019

Revised Provider Manual Chapters (Updated 5/3/19)
05/01/2019-06/01/2019

CMAP Addendum B April 2019 (Updated 5/2/19)
04/18/2019-05/29/2019

Attention Ambulatory Surgical Center Providers: Claim Denial Issue (Posted 4/18/19)
04/17/2019-06/01/2019

Attention Hospital Providers: DRG Calculator Updated (Posted 4/17/19)
04/17/2019-05/14/2019

Electronic Visit Verification (EVV) Providers - Mobile Visit Verification (MVV) Schedule Issue (Updated 4/17/19)
04/16/2019-04/19/2019

Attention All Providers: Automated Voice Response System Downtime Notification (Posted 4/16/19)
04/15/2019-06/11/2019

Electronic Visit Verification Implementation Important Message (Updated 4/15/19)
04/12/2019-06/15/2019

Attention: Primary Care Providers (Posted 4/12/19)
04/09/2019-05/13/2019

Hospital Monthly Important Message (Posted 4/09/19)
04/08/2019-05/09/2019

Attention Ophthalmology Providers: Billing Guidance Concerning Off-label Use of Avastin (Bevacizumab) (Posted 4/8/19)
04/03/2019-04/16/2019

Attention Electronic Visit Verification (EVV) Service Providers: Mobile Visit Verification (MVV) Intermittent Schedule Issue (Posted 4/3/19)
03/29/2019-05/14/2019

Attention DME Hearing Aid Providers: Changes to Claim Submission of Select Hearing Aid Codes for Clients with Medicare Part B (Posted 3/29/19)
03/29/2019-05/14/2019

Attention: Primary Care Providers (Posted 3/29/19)
03/29/2019-05/14/2019

Attention: Homemaker/Companion Agencies Referrals (Posted 3/29/19)
03/12/2019-04/08/2019

Hospital Monthly Important Message (Posted 3/12/19)
03/08/2019-04/08/2019

Electronic Visit Verification (EVV) Providers Mobile Visit Verification (MVV) App Mandatory Update (Posted 3/8/19)
03/06/2019-05/01/2019

Attention Ambulance Providers: Vehicle Registration Information Requirements (Posted 3/6/19)
03/05/2019-05/14/2019

Attention: Providers of Department of Developmental Services (DDS) Specialized Services to Clients Residing in a Nursing Facility (Posted 3/5/19)
03/04/2019-03/05/2019

Attention Providers: Delayed Opening Notification (Posted 03/04/19)
03/01/2019-04/01/2019

Revised Provider Manual Chapters (Updated 3/1/19)
02/25/2019-05/14/2019

Attention ABI Waiver Providers: A Message Regarding the Renewal of the ABI 2 Waiver (Posted 2/25/19)
02/21/2019-02/25/2019

Attention Providers: Automated Voice Response System Downtime Notification (Posted 2/21/19)
02/14/2019-04/05/2019

Attention Autism Waiver Service Providers: Electronic Visit Verification (EVV) Mandated Service Codes (2/13/19)
02/12/2019-02/12/2019

ATTENTION ALL PROVIDERS: Call Center Closure (Posted 2/12/19)
02/12/2019-03/11/2019

Hospital Monthly Important Message (Posted 2/12/19)
01/30/2019-05/01/2019

CMAP Addendum B January 2019 (Updated 1/30/19)
01/24/2019-04/30/2019

Attention Primary Care Providers: Billing of Influenza Products (Posted 1/24/19)
01/10/2019-03/31/2019

Attention NEMT Ambulance Providers (Posted 1/11/19)
01/09/2019-04/22/2019

Electronic Visit Verification Implementation Important Message (Updated 1/8/19)
01/08/2019-02/08/2019

Waiver Providers Fee Schedule Updated (Posted 1/8/19)
01/08/2019-02/11/2019

Hospital Monthly Important Message (Posted 1/8/19)
01/03/2019-01/18/2019

Autism Disorder Procedure Code 97153 Revised (Posted 1/3/19)
01/02/2019-03/10/2019

Attention Providers: Fee Schedule Update Notification (Posted 1/2/19)
  
+ 2018 Important Messages Archived
  
+ 2017 Important Messages Archived
  
+ 2016 Important Messages Archived
  
+ 2015 Important Messages Archived
  
+ 2014 Important Messages Archived
  
- 2019 RA Banner Announcements Archived
Banner Effective DateProvidersBanner Page Announcement
11/22/2019-11/29/2019Attention Community First Choice (CFC) Waiver Fiscal IntermediaryAttention Community First Choice (CFC) Waiver Fiscal Intermediary. REPROCESSED THIS CYCLE: The Department of Social Services (DSS) has requested that DXC reprocess CFC or CFC Money Follows the Person (MFP), ABI, PCA and CHC client claims with dates of service in 2017, that previously denied for EOB code 0512- "Timely Filing Limit Exceeded", 3003 - "PA Required", 3015- "Care Plan Required" or 3016- "Service not Covered Under Care Plan". These claims have been reprocessed and will appear on the November 26, 2019 Remittance Advise (RA) with an Internal Control Number (ICN) beginning with a Region code 27 for new day claims or 52 for adjusted claims.
11/22/2019-11/29/2019Attention 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 November 22, 2019 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your November 26, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
11/22/2019-11/29/2019Attention 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 November 26, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
11/22/2019-11/29/2019Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the November 22, 2019 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your November 26, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
11/22/2019-11/29/2019Attention DME ProvidersAttention DME Providers. IMPLEMENTATION OF DIAGNOSIS REQUIREMENTS FOR DURABLE MEDICAL EQUIPMENT CLAIMS: Effective for dates of service January 1, 2019 and forward, the Department of Social Services (DSS) is fully implementing its Medical Equipment, Devices and Supplies (MEDS) claim submission diagnosis code requirements as previously announced in Provider Bulletin 2019-56. Effective for all MEDS claims with "from" dates of service January 1, 2019 and forward, the diagnosis code from the prescription/written order must be included at the header of the claim. All claims submitted without a diagnosis code will DENY and post Explanation of Benefits (EOB) code 258 - Primary Diagnosis Code Missing.
11/08/2019-11/15/2019Attention Outpatient HospitalAttention Outpatient Hospital. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed outpatient claims for clients with the Tuberculosis benefit plan that processed without a Tuberculosis diagnosis code. DXC Technology has reprocessed and denied the outpatient claims with Explanation of Benefit (EOB) code 4745 "Diagnosis Code Restriction under Client's Benefit Plan" in the November 8, 2019 claim cycle. The claims will appear on the November 13, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 50.
11/08/2019-11/15/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 November 13, 2019 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 November 13, 2019 RA with an ICN beginning with region code 27.
10/18/2019-10/25/2019Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: DXC Technology has identified a claims processing issue where details on certain claims were denied in error for EOB 4963 -"Gender is restricted for procedure code under provider contract" and/or EOB 4801 -"Procedure is not covered. Check Prior Authorization, FTC, Referring Provider, Quantity Restrictions". The impacted claims have been reprocessed and will appear on your October 23, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 or 27.
10/04/2019-10/11/2019Attention Prescribing ProvidersAttention Prescribing Providers. ATTENTION PRESCRIBERS: Effective October 16, 2019, prescriptions for all opioid medications must include a valid International Statistical Classification of Diseases and Related Health Problems (ICD-10) diagnosis code supporting medical necessity from the prescriber in order for the pharmacy claim to process. Claims for opioid medications submitted on or after October 16, 2019 without a diagnosis code will deny. For additional information, please refer to provider bulletin PB19-67. This bulletin can be accessed by going to www.ctdssmap.com, select Information, then Publications. In the Bulletin Search panel select 19 from the Year drop down and enter 67 in the Number field and then click on search
10/04/2019-10/11/2019Attention Community First Choice (CFC) Fiscal IntermediaryAttention Community First Choice (CFC) Fiscal Intermediary. REPROCESSED THIS CYCLE: The Department of Social Services (DSS) has requested that DXC reprocess CFC or CFC Money Follows the Person (MFP) client claims with dates of service in 2017, that previously denied EOB code 3003, "PA Required", 3015 "Care Plan Required" or 3016, "Service not Covered Under Care Plan". These claims have been reprocessed and will appear on the October 8, 2019 Remittance Advise (RA) with an Internal Control Number (ICN) beginning with a Region code 27.
10/04/2019-10/11/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 October 8, 2019 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 October 8, 2019 RA with an ICN beginning with region code 27.
10/04/2019-10/11/2019Attention Inpatient HospitalAttention Inpatient Hospital. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed inpatient claims with dates of admission January 1, 2015 and forward that processed at the behavioral health rates but should have processed at the Diagnostic Related Group (DRG) rate. DXC Technology has reprocessed the inpatient claims at the DRG rate in the October 4, 2019 claim cycle and the claims appear on the October 8, 2019 RA with an ICN beginning with region code 52.
09/20/2019-09/27/2019Attention Primary Care ProvidersAttention Primary Care Providers. REPROCESSED THIS CYCLE: DXC Technology 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 September 24, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52.
09/20/2019-09/27/2019Attention 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 September 24, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
09/20/2019-09/27/2019Attention 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 September 24, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
09/06/2019-09/13/2019Attention Select ProvidersAttention Select Providers. ACCOUNTS RECEIVABLE TRANSACTIONS: DXC Technology has identified a patient liability issue. When a claim was mass adjusted for a rate change and the allowed amount on a claim was less than the client's patient liability, an Account Receivable (AR) was created taking too much patient liability. DXC Technology created an expenditure to pay out to the provider the difference between the allowed amount and the full patient liability. It will appear on your September 10, 2019 Remittance Advice (RA) under Non-Claim Specific Payouts.
09/06/2019-09/13/2019Attention Extended Care Facilities, Hospice Agencies and State InstitutionsAttention Extended Care Facilities, Hospice Agencies and State Institutions. PATIENT LIABILITY MASS ADJUSTMENTS: DXC Technology has identified a mass adjustment issue where patient liability was not taken on a claim resulting in an overpayment to the provider. DXC Technology has identified and adjusted the claims which processed incorrectly. The adjustments will appear on the September 10, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 53 and Explanation of Benefits (EOB) code 8135 "Claim Adjusted Due to Patient Liability Change" and EOB 589 "Mass Adjustment".
09/06/2019-09/13/2019Attention Select Long Term Care ProvidersAttention Select Long Term Care Providers. REPROCESSED THIS CYCLE: DXC Technology has identified an issue where nursing home claims were recouped due to a date of death eligibility issue. The eligibility issue was corrected, and the claims were reprocessed in the September 6, 2019 claim cycle. These claims will appear on the September 10, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27.
09/06/2019-09/13/2019Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the September 6, 2019 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your September 10, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
09/06/2019-09/13/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 September 10, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
09/06/2019-09/13/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 September 10, 2019 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 September 10, 2019 RA with an ICN beginning with region code 27.
09/06/2019-09/13/2019Attention 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 September 6, 2019 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your September 10, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
08/23/2019-08/30/2019Attention 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 August 28, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
08/15/2019-08/21/2019Attention Department of Developmental Services (DDS) Billing ProvidersAttention Department of Developmental Services (DDS) Billing Providers. Special Rate Mass Adjustment Cycle: The Department of Social Services (DSS) has requested that DXC Technology run a special rate mass adjustment cycle due to recent Fiscal Year 2018 rate changes to adjust paid DDS claims with dates of service July 1, 2017 - June 30, 2018. These claims will process in the August 15, 2019 special cycle and will appear on your August 20, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region 55.
08/09/2019-08/14/2019Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the August 9, 2019 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your August 13, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
08/09/2019-08/14/2019Attention All ProvidersREPROCESSED THIS CYCLE: DXC Technology 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 August 13, 2019 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 August 13, 2019 RA with an ICN beginning with region code 27.
08/09/2019-08/14/2019Attention 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 August 9, 2019 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your August 13, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
07/19/2019-07/26/2019Attention Durable Medical Equipment (DME) ProvidersAttention Durable Medical Equipment (DME) Providers. NEW EDITS: The Department of Social Services (DSS) is implementing new edits to validate the provider type/specialty of the ordering, referring and rendering provider listed on claims submitted by DME providers. The following new Explanation of Benefit (EOB) codes will post to claims submitted with dates of service on or after 8/1/2019 and deny the detail for invalid provider type/specialty: - EOB 0562: Referring provider type/specialty not valid for billing provider - EOB 0563: Ordering provider type/specialty not valid for billing provider - EOB 0564: Rendering provider type/specialty not valid for billing provider
07/19/2019-07/26/2019Attention 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 July 23, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
07/05/2019-07/12/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 July 9, 2019 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 July 9, 2019 RA with an ICN beginning with region code 27.
07/05/2019-07/12/2019Attention Outpatient HospitalsAttention Outpatient Hospitals. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed outpatient and outpatient crossover claims that were processed between July 25, 2018 and March 26, 2019 that contained a procedure code with modifier GZ "Not Reasonable and Necessary" that denied due to not assigning a status indicator to that procedure code. The impacted claims have been identified and reprocessed and will appear on your July 9, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
06/21/2019-06/28/2019Attention 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 June 25, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/21/2019-06/28/2019Attention Primary Care ProvidersAttention Primary Care Providers. REPROCESSED THIS CYCLE: DXC Technology 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 June 25, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52.
06/21/2019-06/28/2019Attention 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 June 25, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/21/2019-06/28/2019Attention Select Free-Standing Renal Dialysis ClinicAttention Select Free-Standing Renal Dialysis Clinic. REPROCESSED THIS CYCLE: DXC Technology had identified a claims processing issue regarding services rendered in a Free-Standing Renal Dialysis Clinic setting whereby claims submitted by the Dialysis Clinic were denied in error as a duplicate against the physician claims, if the physician claim was submitted first. The issue has been corrected and the Dialysis Clinic claims are no longer denying as a duplicate against the physician claims. The impacted claims have been identified and reprocessed and will appear on your June 25, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27.
06/21/2019-06/28/2019Attention Ambulatory Surgical CentersAttention Ambulatory Surgical Centers. REPROCESSED THIS CYCLE: DXC Technology had identified a claims processing issue regarding services rendered in an Ambulatory Surgical Center (ASC) setting whereby claims submitted by the ASC were denying in error as a duplicate against the physician claims, if the physician claim was submitted first. The issue has been corrected and the ASC claims are no longer denying as a duplicate against the physician claims. The impacted claims have been identified and reprocessed and will appear on your June 25, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52.
06/21/2019-06/28/2019Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the June 21, 2019 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your June 25, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
06/21/2019-06/28/2019Attention Department of Administrative Services (DAS) Billing ProvidersAttention Department of Administrative Services (DAS) Billing Providers. QUARTERLY TIMELY FILING EDIT OVERRIDE: The Department of Social Services (DSS) has requested that DXC Technology perform an ongoing quarterly timely filing override, upon request, for claims submitted by DAS that would otherwise deny for timely filing. DXC Technology will be performing a timely filing edit override in the June 21, 2019 financial cycle of claims submitted by DAS that would otherwise be impacted by the timely filing edits. These claims will appear on your June 25, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 20.
06/21/2019-06/28/2019Attention 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 June 21, 2019 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your June 25, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
06/21/2019-06/28/2019Attention All ProvidersAttention All Providers. HOLIDAY CLOSURE: Please be advised, the Department of Social Services (DSS) and DXC Technology will be closed on Thursday, July 4, 2019 in observance of the Independence Day holiday. Both the DSS and DXC Technology offices will re-open on Friday, July 5, 2019.
06/21/2019-06/28/2019Attention Select ProvidersAttention Select Providers. CORRECTED 2018 1099 FORMS: The Department of Social Services wishes to inform providers that a subset of 2018 1099-MISC Tax forms issued to providers at the beginning of 2019 underreported their 2018 earnings. The cause of this error has been identified and resolved and the corrected 1099-MISC Tax forms will be mailed to providers in July, 2019. The corrected 1099 file will be sent to the Internal Revenue Service (IRS) by the end of the summer. We wish to apologize for this inconvenience.
06/14/2019-06/20/2019Attention Inpatient HospitalsAttention Inpatient Hospitals. DIAGNOSTIC RELATED GROUP (DRG) REPROCESSING: DXC Technology is releasing the mass adjusted claims that were previously processed using V35 DRG weight, ALOS (Average Length of Stay) or outlier amount. Any inpatient claims with a discharge date of October 1, 2018 to November 13, 2018 that was previously suspended in February will now process at the V36 DRG weight, ALOS and outlier amount and will appear on your June 18, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/14/2019-06/20/2019Attention Department of Developmental Services (DDS) Billing ProvidersAttention Department of Developmental Services (DDS) Billing Providers. Special Rate Mass Adjustment Cycle: The Department of Social Services (DSS) has requested that DXC Technology run a special rate mass adjustment cycle due to recent Fiscal Year 2017 rate changes to adjust paid DDS claims with dates of service July 1, 2016 - June 30, 2017. These claims will process in the June 14, 2019 special cycle and will appear on your June 18, 2019 Remittance Advise (RA) with an Internal Control Number (ICN) beginning with a region 55.
06/07/2019-06/13/2019Attention Ambulance ProvidersAttention Ambulance Providers. ATTENTION AMBULANCE PROVIDERS: Per provider bulletin 2019-05 titled Vehicle Registration Information Requirements, effective March 1, 2019, the Department of Social Services (DSS) requires all in-state ambulance providers to have vehicle registration information on file. In-state ambulance providers are required to have a valid Vehicle Identification Number (VIN) on all registered vehicles and will need to provide that information to DXC Technology. Failure to provide the ambulance's current VIN(s) will cause the ambulance provider to be dis-enrolled from the Connecticut Medical Assistance Program (CMAP) and claims will not be processed after the dis-enrollment date. The ambulance provider will then be required to re-enroll with CMAP. DSS will soon begin to validate registrations directly with the Connecticut Department of Motor Vehicles (DMV). All ambulance providers need to make sure their vehicles' registrations remain current with the DMV, as failure to remain current will cause the ambulance provider to be dis-enrolled from CMAP.
06/07/2019-06/13/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 June 11, 2019 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 June 11, 2019 RA with an ICN beginning with region code 27.
06/07/2019-06/13/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 June 11, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
06/07/2019-06/13/2019Attention Medical & Tribal Services Medical Federally Qualified Health Centers (FQHCs)Attention Medical & Tribal Services Medical Federally Qualified Health Centers (FQHCs). PERFORMING PROVIDERS REQUIRED FOR SELECT FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS): Effective for dates of service July 1, 2019 and forward, the Department of Social Services (DSS) is implementing system changes that will require all performing providers employed by or contracted with Medical & Tribal Services Medical Federally Qualified Health Centers (FQHCs) who render services to HUSKY Health members to be enrolled in the Connecticut Medical Assistance Program (CMAP) and to be associated to that FQHC for the claim date of service. For dates of service July 1, 2019 and forward, claims will no longer post and pay; instead, they will deny if a valid/enrolled performing provider's National Provider Identifier (NPI) is not present on the claim, or if the performing provider is not associated to the clinic. Please refer to provider bulletin 2019-21 for further instructions.
06/07/2019-06/13/2019REPROCESSED THIS CYCLE: The Department of Social Services (DSS) has identified and corrected the issue that resulted in overpayments of Applied Income in the May 10, 2019 claim cycle. DSS has identified and reprocessed the affected claims in the June 7, 2019 claim cycle. The new claims will appear on the June 11, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 5319157.
05/24/2019-05/31/2019Attention Medical & Tribal Services Medical Federally Qualified Health Centers (FQHCs)Attention Medical & Tribal Services Medical Federally Qualified Health Centers (FQHCs). PERFORMING PROVIDERS REQUIRED FOR SELECT FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS): Effective for dates of service July 1, 2019 and forward, the Department of Social Services (DSS) is implementing system changes that will require all performing providers employed by or contracted with Medical & Tribal Services Medical Federally Qualified Health Centers (FQHCs) who render services to HUSKY Health members to be enrolled in the Connecticut Medical Assistance Program (CMAP) and to be associated to that FQHC for the claim date of service. For dates of service July 1, 2019 and forward, claims will no longer post and pay; instead, they will deny if a valid/enrolled performing provider's National Provider Identifier (NPI) is not present on the claim, or if the performing provider is not associated to the clinic. Please refer to provider bulletin 2019-21 for further instructions.
05/24/2019-05/31/2019Attention Inpatient HospitalAttention Inpatient Hospital. REPROCESSED THIS CYCLE: DSS updated the Diagnostic Related Group (DRG) weights, Average Length of Stay (ALOS) and Outlier Threshold for DRG codes 5891 - 5894 on February 14, 2019 effective for date of discharges October 1, 2015 to September 30, 2018. Any inpatient claims with a discharge date of October 1, 2015 and forward that processed between May 11, 2018 and February 14, 2019 were processed at the incorrect DRG weight, ALOS or outlier amount. The impacted claims have been identified and reprocessed and will appear on your May 29, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 50.
05/24/2019-05/31/2019Attention Select ProvidersAttention Select Providers. PCMH+ Reprocess: DXC Technology has identified an issue that resulted in duplicate payments of the November benefit month as the December 2018 benefit month. DXC Technology has recouped the duplicate payments and reprocessed the December benefit information. Providers will see these transactions posted under the "Financial Transactions" section of the May 29, 2019 Remittance Advice (RA).
05/24/2019-05/31/2019Attention Ambulance ProvidersAttention Ambulance Providers. ATTENTION AMBULANCE PROVIDERS: Per provider bulletin 2019-05 titled Vehicle Registration Information Requirements, effective March 1, 2019, the Department of Social Services (DSS) requires all in-state ambulance providers to have vehicle registration information on file. In-state ambulance providers are required to have a valid Vehicle Identification Number (VIN) on all registered vehicles and will need to provide that information to DXC Technology. Failure to provide the ambulance's current VIN(s) will cause the ambulance provider to be dis-enrolled from the Connecticut Medical Assistance Program (CMAP) and claims will not be processed after the dis-enrollment date. The ambulance provider will then be required to re-enroll with CMAP. DSS will soon begin to validate registrations directly with the Connecticut Department of Motor Vehicles (DMV). All ambulance providers need to make sure their vehicles' registrations remain current with the DMV, as failure to remain current will cause the ambulance provider to be dis-enrolled from CMAP. Ambulance providers can provide their VIN(s) for their fleet of ambulances by logging on to their Secure Web portal account at www.ctdssmap.com and using the "Maintain Vehicle Information" panel. Please refer to provider bulletin 2019-05 for further instructions.
05/24/2019-05/31/2019Attention 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 May 29, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
05/10/2019-05/17/2019Attention Providers of Department of Developmental Services (DDS) Specialized Services to Clients Residing in a Nursing FacilityAttention Providers of Department of Developmental Services (DDS) Specialized Services to Clients Residing in a Nursing Facility. REPROCESSED THIS CYCLE: As communicated to providers via prior banner messages, DXC Technology has been working with DDS to receive valid prior authorization (PA) files for the payment of claims for DDS Specialized Services to clients residing in a nursing facility effective for dates of service February 1, 2019 and forward. DXC Technology has received confirmation from DDS that valid service authorizations are now on file for some claims that previously denied for Explanation of Benefit (EOB) code 3003 - "Prior Authorization Required for Payment of this Service". As a result, denied claims have been identified and reprocessed. The reprocessed claims include those that previously denied with EOB code 877 - "Quantity disagrees with days lapsed." These claims will appear on your May 14, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 27 or 52.
05/10/2019-05/17/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 May 14, 2019 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 May 14, 2019 RA with an ICN beginning with region code 27.
05/10/2019-05/17/2019Attention Medical & Tribal Services Medical Federally Qualified Health Centers (FQHCs)Attention Medical & Tribal Services Medical Federally Qualified Health Centers (FQHCs). PERFORMING PROVIDERS REQUIRED FOR SELECT FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS): Effective for dates of service July 1, 2019 and forward, the Department of Social Services (DSS) is implementing system changes that will require all performing providers employed by or contracted with Medical & Tribal Services Medical Federally Qualified Health Centers (FQHCs) who render services to HUSKY Health members to be enrolled in the Connecticut Medical Assistance Program (CMAP) and to be associated to that FQHC for the claim date of service. For dates of service July 1, 2019 and forward, claims will no longer post and pay; instead, they will deny if a valid/enrolled performing provider's NPI is not present on the claim, or if the performing provider is not associated to the clinic. Please refer to provider bulletin 2019-21 for further instructions.
05/10/2019-05/17/2019Attention Ambulance ProvidersAttention Ambulance Providers. ATTENTION AMBULANCE PROVIDERS: Per provider bulletin 2019-05 titled Vehicle Registration Information Requirements, effective March 1, 2019, the Department of Social Services (DSS) requires all in-state ambulance providers to have vehicle registration information on file. In-state ambulance providers are required to have a valid Vehicle Identification Number (VIN) on all registered vehicles and will need to provide that information to DXC Technology. Failure to provide the ambulance's current VIN(s) will cause the ambulance provider to be dis-enrolled from the Connecticut Medical Assistance Program (CMAP) and claims will not be processed after the dis-enrollment date. The ambulance provider will then be required to re-enroll with CMAP. DSS will soon begin to validate registrations directly with the Connecticut Department of Motor Vehicles (DMV). All ambulance providers need to make sure their vehicles' registrations remain current with the DMV, as failure to remain current will cause the ambulance provider to be dis-enrolled from CMAP. Ambulance providers can provide their VIN(s) for their fleet of ambulances by logging on to their Secure Web portal account at www.ctdssmap.com and using the "Maintain Vehicle Information" panel. Please refer to provider bulletin 2019-05 for further instructions.
04/18/2019-04/26/2019Attention Ambulance ProvidersAttention Ambulance Providers. ATTENTION AMBULANCE PROVIDERS: Per provider bulletin 2019-05 titled Vehicle Registration Information Requirements, effective March 1, 2019, the Department of Social Services (DSS) requires all in-state ambulance providers to have vehicle registration information on file. In-state ambulance providers will be required to have a valid Vehicle Identification Number (VIN) on all registered vehicles and will need to provide that information to DXC Technology. Failure to provide the ambulance's current VIN(s) will cause the ambulance provider to be dis-enrolled from the Connecticut Medical Assistance Program (CMAP) on May 1, 2019 and claims will not be processed after the dis-enrollment date. The ambulance provider will then be required to re-enroll with CMAP. As of May 1, 2019, DSS will be validating registrations directly with the Connecticut Department of Motor Vehicles (DMV). All ambulance providers need to make sure their vehicles' registrations remain current with the DMV, failure to remain current will cause the ambulance provider to be dis-enrolled from CMAP. Ambulance providers can provide their VIN(s) for their fleet of ambulances by logging on to their Secure Web portal account at www.ctdssmap.com and using the "Maintain Vehicle Information" panel. Please refer to provider bulletin 2019-05 for further instructions.
04/18/2019-04/26/2019Attention 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 April 18, 2019 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your April 23, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
04/18/2019-04/26/2019Attention 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 April 23, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
04/05/2019-04/12/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 April 9, 2019 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 April 9, 2019 RA with an ICN beginning with region code 27.
04/05/2019-04/12/2019Attention Providers of Department of Developmental Services (DDS) Specialized Services to Clients Residing in a Nursing FacilityAttention Providers of Department of Developmental Services (DDS) Specialized Services to Clients Residing in a Nursing Facility. DDS PRIOR AUTHORIZATION FILE RECEIVED: This message is to notify providers that DXC Technology has received a valid Prior Authorization (PA) file from DDS for the authorization of DDS Specialized Services to clients residing in a Nursing Facility. Providers, however, are encouraged to verify that a PA is on file for the provider, client, procedure code, date of service and units to be billed, for the services they will be providing, before submitting claims. As a reminder, claims submitted for services that do not have PA will deny for Explanation of Benefits Code (EOB) - 3003 "Prior Authorization is Required for Payment of this Service." Claims that previously denied for EOB 3003 will be reprocessed by DXC Technology in a future financial cycle. Providers will be notified via a Banner Page message when this will occur.
04/05/2019-04/12/2019Attention Hearing Aid ProvidersAttention Hearing Aid Providers. BILLING CHANGES: Effective immediately, the following procedure codes can be billed directly to Medicaid when the member is a dual eligible with Original Medicare Part B: V5010, V5011, V5014, V5030, V5040, V5050, V5060, V5090, V5120, V5130, V5140, V5160, V5171, V5172, V5181, V5200, V5211, V5212, V5213, V5214, V5215, V5221, V5240, V5241, V5254, V5255, V5256, V5257, V5258, V5259, V5260, V5261, V5264, V5266, V5267, V5274 and V5298. For dual eligible members who have Medicare Advantage Plans (Part C), providers must check with the Medicare Part C plan every year and obtain documentation that verifies the benefit exclusion for that calendar year. Once the exclusion is verified, the hearing aid provider can submit the claim for the codes specified above directly to Medicaid. Please refer to the Important Message titled "Attention DME Hearing Aid Providers - Changes to Claim Submission of Select Hearing Aid Codes for Clients with Medicare Part B" posted to the Home page of the www.ctdssmap.com Web site for additional information.
04/05/2019-04/12/2019Attention 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 April 5, 2019 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your April 9, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
03/22/2019-03/29/2019Attention Primary Care ProvidersAttention Primary Care Providers. REPROCESSED THIS CYCLE: DXC Technology 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 26, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
03/22/2019-03/29/2019Attention Outpatient HospitalsAttention Outpatient Hospitals. CONNECTICUT MEDICAL ASSISTANCE PROGRAM (CMAP) ADDENDUM B REPROCESSING: 1. DXC Technology has adjusted all outpatient and outpatient crossover claims impacted by Ambulatory Payment Classification (APC) weight changes, status indicator changes, and other changes indicated by an "X" in the change field on the CMAP Addendum B. Outpatient and outpatient crossover claims with dates of services between January 1, 2019 to February 26, 2019 that were processed prior to the availability of the Addendum B updates were adjusted in the March 22, 2019 claim cycle and the claims will appear on the March 26, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 55. 2. DXC Technology also identified any outpatient and outpatient crossover claims that processed prior to the availability of the Addendum B updates for "NEW"procedure codes and re-processed the claims in the March 22, 2019 claim cycle. These claims will appear on the March 26, 2019 RA with an ICN beginning with a region code 61 or 27.
03/22/2019-03/29/2019Attention 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 26, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/22/2019-03/29/2019Attention 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 26, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/22/2019-03/29/2019Attention All ProvidersAttention All Providers. NEW PROVIDER WORKSHOP: Newly enrolled providers or new business office staff are invited to register for and attend the New Provider Workshop to be held on Friday, March 29, 2019 at the Connecticut Hospital Association. 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.
03/22/2019-03/29/2019Attention Providers of Department of Developmental Services (DDS) Specialized Services to Clients Residing in a Nursing FacilityAttention Providers of Department of Developmental Services (DDS) Specialized Services to Clients Residing in a Nursing Facility. DELAY IN PRIOR AUTHORIZATION: Effective for dates of service February 1, 2019 and forward, providers of DDS Specialized Services to clients residing in a Nursing Facility must submit claims directly to DXC Technology to be reimbursed by the Department of Social Services (DSS). Providers are reminded that reimbursement for services provided to a nursing facility resident are contingent upon a Prior Authorization (PA) from DDS being on file for the provider, client, procedure code, date of service and units billed. This message is to notify providers that DXC Technology is working with DDS to assist in the submission of a valid PA file for the authorization of DDS Specialized Services. As a result, until this issue is resolved, providers should verify PA via their Secure Web portal account at www.ctdssmap.com, by selecting Prior Authorization Inquiry from the Prior Authorization menu. Claims submitted for services that do not have PA will deny. Once DXC Technology receives a valid PA file from DDS, claims that denied for Explanation of Benefit (EOB) code 3003 - "Prior Authorization Required for Payment of this Service", as a result of the delay in receipt of PA, will be identified and reprocessed. Providers will be notified via a Banner Page message on a future Remittance Advice when this reprocessing will occur.
03/22/2019-03/29/2019Attention 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 22, 2019 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your March 26, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
03/22/2019-03/29/2019Attention Ambulance ProvidersAttention Ambulance Providers. ATTENTION AMBULANCE PROVIDERS: Per provider bulletin 2019-05 titled Vehicle Registration Information Requirements, effective March 1, 2019, the Department of Social Services (DSS) requires all in-state ambulance providers to have vehicle registration information on file. In-state ambulance providers will be required to have a valid Vehicle Identification Number (VIN) on all registered vehicles and will need to provide that information to DXC Technology. Failure to provide the ambulance's current VIN(s) will cause the ambulance provider to be dis-enrolled from the Connecticut Medical Assistance Program (CMAP) and claims will not be processed after the dis-enrollment date. The ambulance provider will then be required to re-enroll with CMAP. In the future, DSS will be validating registrations directly with the Connecticut Department of Motor Vehicles (DMV). All ambulance providers need to make sure their vehicles' registrations remain current with the DMV. Ambulance providers can provide their VIN(s) for their fleet of ambulances by logging on to their Secure Web portal account at www.ctdssmap.com and using the "Maintain Vehicle Information" panel. Please refer to provider bulletin 2019-05 for further instructions.
03/08/2019-03/15/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 12, 2019 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 12, 2019 RA with an ICN beginning with region code 27.
03/08/2019-03/15/2019Attention: Providers of Department of Developmental Services (DDS) Specialized Services to Clients Residing in a Nursing FacilityAttention: Providers of Department of Developmental Services (DDS) Specialized Services to Clients Residing in a Nursing Facility. Effective for dates of service February 1, 2019 and forward, providers of DDS Specialized Services to clients residing in a Nursing Facility must submit claims directly to DXC Technology to be reimbursed by the Department of Social Services (DSS). Providers are reminded that reimbursement for services provided to a nursing facility resident are contingent upon a Prior Authorization (PA) from DDS being on file for the provider, client, procedure code, date of service and units billed. This message is to notify providers that DXC Technology is working with DDS to assist in the submission of a valid PA file for the authorization of DDS Specialized Services. As a result, until this issue is resolved, providers should verify PA via their Secure Web portal account at www.ctdssmap.com, by selecting Prior Authorization Inquiry from the Prior Authorization menu. Claims submitted for services that do not have PA will deny. Once DXC Technology receives a valid PA file from DDS, claims that denied for Explanation of Benefit (EOB) code 3003 - "Prior Authorization Required for Payment of this Service", as a result of the delay in receipt of PA will be identified and reprocessed. Providers will be notified via a Banner Page message on a future Remittance Advice when this reprocessing will occur.
03/08/2019-03/15/2019Attention Electronic Visit Verification (EVV) ProvidersAttention Electronic Visit Verification (EVV) Providers. Important Mandatory Mobile Visit Verification (MVV) Update for Android Users: All employees who use the MVV time capture application on an Android phone must upgrade to the new 4.6.0 version before March 18, 2019. This upgrade will be available as of March 8, 2019. If an employee fails to upgrade their Android to the new MVV version 4.6.0 by March 18, 2019, the application will cease to function. A new version for iOS users will become available in the Apple App Store within two weeks, however, the MVV app will continue to function in older versions. We strongly encourage iOS users to upgrade as soon as the upgrade is available. If you have any questions or comments, please contact Sandata Customer Care at 1-800-855-3990.
03/08/2019-03/15/2019Attention 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 8, 2019 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your March 12, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
03/08/2019-03/15/2019Attention Ambulatory Surgical Centers, Rehabilitation Clinic, Pediatric Clinic and Free-Standing Renal Dialysis Clinic ProvidersAttention Ambulatory Surgical Centers, Rehabilitation Clinic, Pediatric Clinic and Free-Standing Renal Dialysis Clinic Providers. PERFORMING PROVIDERS REQUIRED FOR SELECT CLINIC PROVIDERS: Effective for dates of service March 1, 2019 and forward, the Department of Social Services (DSS) implemented system changes that require all performing providers employed by or contracted with Ambulatory Surgical Centers, Rehabilitation Clinic, and Free Standing Renal Dialysis Clinic providers who render services to HUSKY Health members be enrolled in the Connecticut Medical Assistance Program (CMAP) and to be associated to that Clinic for the claim date of service. For dates of service March 1, 2019 and forward, claims are denying if the performing provider is not enrolled in CMAP, a valid/enrolled performing provider's NPI is not present on the claim, or if the performing provider is not associated to the clinic. Please refer to provider bulletin 2018-86 for further instructions.
03/08/2019-03/15/2019Attention All ProvidersAttention All Providers. NEW PROVIDER WORKSHOP: Newly enrolled providers or new business office staff are invited to register for and attend the New Provider Workshop to be held on Friday, March 29, 2019 at the Connecticut Hospital Association. 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.
02/22/2019-03/01/2019Attention Autism Waiver Service ProvidersAttention Autism Waiver Service Providers. ELECTRONIC VISIT VERIFICATION (EVV) TO BE IMPLEMENTED ON MARCH 3, 2019: Providers should be aware that the Autism waiver will be implemented in the EVV program on March 3, 2019. If your agency has not completed the mandatory training, your agency will not receive the EVV Welcome Kit and will not be able to access the Santrax system to capture EVV visit data. To complete the mandatory training, please refer to the Electronic Visit Verification Implementation Important Message and navigate to the Training Publications and Videos subheading to enroll in the Learning Management Systems (LMS) and access the Web based training.
02/22/2019-03/01/2019Attention 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 26, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
02/22/2019-03/01/2019Attention Pharmacy ProvidersAttention Pharmacy Providers. INACTIVE ACCOUNTS RECEIVABLE: The February 13, 2019 Remittance Advice (RA) incorrectly identified claims suspended due to the temporary client ID reprocess under the Accounts Receivable (AR) section of the RA. The claims identified have been deleted and no monies have been recouped from providers. The inactivated ARs will appear on the February 26, 2019 RA with the following expenditure reason: 8310 -"Reversal of AR Created from Claim Adjustment."
02/22/2019-03/01/2019Attention Ambulance ProvidersAttention Ambulance Providers. ATTENTION AMBULANCE PROVIDERS: Per provider bulletin 2019-05 titled Vehicle Registration Information Requirements, effective March 1, 2019, the Department of Social Services (DSS) requires all in-state ambulance providers to have vehicle registration information on file. In-state ambulance providers will be required to have a valid Vehicle Identification Number (VIN) on all registered vehicles and will need to provide that information to DXC Technology. Failure to provide the ambulance's current VIN(s) will cause the ambulance provider to be dis-enrolled from the Connecticut Medical Assistance Program (CMAP) and claims will not be processed after the dis-enrollment date. The ambulance provider will then be required to re-enroll with CMAP. In the future, DSS will be validating registrations directly with the Connecticut Department of Motor Vehicles (DMV). All ambulance providers need to make sure their vehicles' registrations remain current with the DMV. Ambulance providers can provide their VIN(s) for their fleet of ambulances by logging on to their Secure Web portal account at www.ctdssmap.com and using the "Maintain Vehicle Information" panel. Please refer to provider bulletin 2019-05 for further instructions.
02/22/2019-03/01/2019Attention Outpatient HospitalsAttention Outpatient Hospitals. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed crossover claims that previously partially denied for Explanation of Benefit (EOB) code 1033 "Attending Physician not Enrolled on Date of Service". Outpatient crossover claims with EOB 1033 that processed incorrectly were adjusted and the claims will appear on the February 26, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 52.
02/08/2019-02/15/2019Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the February 8, 2019 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your February 13, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
02/08/2019-02/15/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 13, 2019 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 13, 2019 RA with an ICN beginning with region code 27.
02/08/2019-02/15/2019Attention 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 February 8, 2019 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your February 13, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
01/18/2019-01/25/2019Attention Outpatient HospitalsAttention Outpatient Hospitals. CONNECTICUT MEDICAL ASSISTANCE PROGRAM (CMAP) ADDENDUM B REPROCESSING: DXC Technology identified and adjusted all outpatient and outpatient crossover claims impacted by Ambulatory Payment Classification (APC) weight changes effective October 1, 2018. Outpatient claims with dates of services between October 1, 2018 to November 13, 2018 that were processed at the wrong APC weight were adjusted and the claims will appear on the January 23, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 55.
01/18/2019-01/25/2019Attention 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 18, 2019 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your January 23, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
01/18/2019-01/25/2019Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the January 18, 2019 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your January 23, 2019 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
01/18/2019-01/25/2019Attention 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 23, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
01/09/2019-01/16/2019Attention Billing ProviderAttention Billing Provider. REPROCESSED THIS CYCLE: DXC Technology will run a special rate mass adjustment financial cycle beginning January 10, 2019 to reprocess Department of Development Services (DDS) Money Follows the Person (MFP) Comprehensive and Individual Family Services (IFS) claims. These claims will appear on the January 15, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 55.
01/04/2019-01/09/2019Attention Outpatient HospitalsAttention Outpatient Hospitals. REPROCESSED THIS CYCLE: DXC Technology previously identified an issue with outpatient therapy claims that were processed incorrectly that used the incorrect number of units from the therapy prior authorization. Outpatient therapy claims that took the incorrect number of units from the client's prior authorization were adjusted and the prior authorization was corrected. The adjusted outpatient claims appear on your January 8, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
01/04/2019-01/09/2019Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology 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 8, 2019 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 8, 2019 RA with an ICN beginning with region code 27.
01/04/2019-01/09/2019Attention Outpatient HospitalsAttention Outpatient Hospitals. REPROCESSED THIS CYCLE: DXC Technology previously identified an issue with outpatient therapy claims that paid over the therapy flat rate for clients covered under the HUSKY Plus Benefit plan. Outpatient therapy claims with Revenue Center Codes (RCCs) 421, 423, 424, 431, 433, 434, 441, 443 and 444 that paid more than the flat rate under the HUSKY Plus benefit plan were adjusted and appear on your January 8, 2019 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
  
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