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- 2017 Important Messages Archived
Message Effective Date
Title
06/14/2017-06/19/2017
Electronic Visit Verification ABN Training Invitation
06/14/2017-07/18/2017
Hospital Monthly Important Message (Updated 6/14/17)
06/09/2017-06/23/2017
Correction to the June 2017 interChange Newsletter (Posted 6/9/17)
06/09/2017-06/10/2017
Attention Providers: AVRS Extended Downtime Notification (Posted 6/9/17)
06/07/2017-06/20/2017
Tasks Required for Non-skilled Service Providers in the EVV Santrax System
06/05/2017-06/09/2017
Electronic Visit Verification ABN Training Invitation
06/02/2017-06/30/2017
Electronic Visit Verification Implementation (Updated 6/2/17)
06/01/2017-06/06/2017
Attention Providers: AVRS Downtime Notification (Posted 6/1/17)
05/30/2017-06/30/2017
How to Resolve Unexpected Clients in Your Santrax System
05/18/2017-05/23/2017
Attention Outpatient Hospitals: Prior Authorization Requirements for Supprelin (J9226) and PuraPlay (Q4172)
05/15/2017-06/30/2017
Update to the Consent to Sterilization Form Submission, Hysterectomy Information Form and Physician Hysterectomy Certification Form Retroactive Eligibility Submission Process (Posted 5/15/17)
05/10/2017-06/10/2017
Hospital Monthly Important Message (Updated 5/10/17)
05/03/2017-06/01/2017
Electronic Visit Verification Implementation (Updated 5/2/17)
04/17/2017-04/18/2017
Attention Providers: Select Fee Schedules Unavailable (4/17/17)
04/13/2017-05/05/2017
Attention: Licensed Alcohol and Drug Counselors (LADCs) Procedure code 90791 Updated (Posted 4/13/17)
04/11/2017-05/10/2017
Hospital Monthly Important Message (Updated 4/11/17)
04/04/2017-05/31/2017
Hewlett Packard Enterprise Becomes DXC Technology (Posted 4/4/17)
03/28/2017-05/04/2017
Attention All Providers: Electronic Funds Transfer and ASC X12 835 One Day Delay (Posted 3/28/17)
03/16/2017-06/06/2017
Revised Provider Manual Chapters (Updated 3/17/17)
03/15/2017-03/15/2017
Attention Providers: Service Interruption (Posted 3/15/17)
03/13/2017-03/15/2017
Attention Providers: Office Closure (3/14/17)
03/08/2017-04/11/2017
Hospital Monthly Important Message (Updated 3/8/17)
03/07/2017-03/31/2017
Attention Providers: Revised 2017 Medicaid Consolidated Laboratory Fee Schedule (Posted 3/7/17)
03/03/2017-04/15/2017
Attention Providers: CT Medicaid Provider File Request (Posted 3/3/17)
02/16/2017-03/01/2017
Electronic Visit Verification Implementation (Updated 02/16/17)
02/09/2017-02/09/2017
Attention Providers: Office Closure (Posted 2/9/17)
02/08/2017-03/07/2017
Hospital Monthly Important Message (Updated 02/08/17)
01/31/2017-05/04/2017
Attention EVV Providers: Updated EVV Implementation Date for Home Health Providers (Posted 1/31/17)
01/26/2017-02/16/2017
Electronic Visit Verification Implementation (Updated 1/24/17)
01/20/2017-02/28/2017
Attention Providers: CT Medicaid Provider File Request (Posted 1/20/17)
01/11/2017-02/07/2017
Hospital Monthly Important Message (Updated 1/11/17)
+ 2016 Important Messages Archived
+ 2015 Important Messages Archived
+ 2014 Important Messages Archived
- 2017 RA Banner Announcements Archived
Banner Effective Date
Providers
Banner Page Announcement
07/21/2017-07/28/2017
Attention Outpatient Hospitals
Attention Outpatient Hospitals. REPROCESSED THIS CYCLE: DXC Technology identified an issue with outpatient therapy services (RCC 420-421, 424, 430-431, 434, 441 and 444) for dates of service (DOS) July 1, 2016 and forward paying when the service was already paid on a separate outpatient claim in history or another detail on the same claim. The system has been corrected and the outpatient therapy services will now deny with Explanation of Benefit (EOB) code 5000 "Possible Duplicate of a Paid Claim or a Claim that is Currently in Process", or 5001 "Exact Duplicate of a Paid Claim or Claim that is Currently in Process". The impacted outpatient claims have been identified and adjusted and will appear on your July 25, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
07/21/2017-07/28/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. WHO TO CONTACT WITH EVV RELATED QUESTIONS: Providers may have questions about who to contact regarding EVV related issues. If after reviewing the information below you are unsure who to contact for assistance, please send an e-mail to ctevv@dxc.com. You are also encouraged to send an e-mail the ctevv@dxc.com mailbox if you feel you need additional support resolving your issue. Please be sure to include your Sandata ticket number if applicable. If you are missing a client from your Santrax system or have clients that you are unfamiliar with, please send a secure email to ctevv@dxc.com. If a prior authorization (PA) is present on the www.ctdssmap.com portal but is not present in the Santrax system, please send an email to ctevv@dxc.com. If you are experiencing issues with the Santrax system and its functionality please contact Sandata Customer Care. They can be reached at 1-855-399-8050 or by email at ctcustomercare@sandata.com. Important: Do not email client identifying data unless you encrypt your e-mail.
07/21/2017-07/28/2017
Attention Select Providers
Attention 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 25, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
07/21/2017-07/28/2017
Attention Psychologist Providers
Attention Psychologist Providers. REPROCESSED THIS CYCLE: For claims submitted on Friday, July14, 2017, DXC technology identified an issue with Psychologist claims reimbursing more than the allowed amount on the psychologist's fee schedule. The impacted claims have been identified and adjusted and will appear on your July 25, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 50.
07/07/2017-07/14/2017
Attention Home Health Providers
Attention Home Health Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and denied for Explanation of Benefits (EOB) Code 2522, Bill Medicare First or Provide Appropriate Adjustment Reason Code and Date of ABN or NOMNC, on claim details that typically do not cost avoid. The claims were reprocessed and appear on the July 11, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
07/07/2017-07/14/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. WHO TO CONTACT WITH EVV RELATED QUESTIONS: Providers may have questions about who to contact regarding EVV related issues. If after reviewing the information below you are unsure who to contact for assistance, please send an e-mail to ctevv@dxc.com. You are also encouraged to send an e-mail the ctevv@dxc.com mailbox if you feel you need additional support resolving your issue. Please be sure to include your Sandata ticket number if applicable. If you are missing a client from your Santrax system or have clients that you are unfamiliar with, please send a secure email to ctevv@dxc.com. If a prior authorization (PA) is present on the www.ctdssmap.com portal but is not present in the Santrax system, please send an email to ctevv@dxc.com. If you are experiencing issues with the Santrax system and its functionality please contact Sandata Customer Care They can be reached at 1-855-399-8050 or by email at ctcustomercare@sandata.com. Important: Do not email client identifying data unless you encrypt your e-mail.
07/07/2017-07/14/2017
Attention All Providers
Attention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID 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 11, 2017 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 11, 2017 RA with an ICN beginning with region code 27 if the original claim was submitted electronically, or a region code 15 if the original claim was submitted on paper.
07/07/2017-07/14/2017
Attention Pharmacy Providers
Attention Pharmacy Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and erroneously denied Compound Pharmacy Claims for Explanation of Benefits (EOB) Code 2509 - Bill Medicare First, EOB Code 2514 - Medicare Eligible Client Must Enroll in Part D, EOB Code 2802 - Program Requires Copay Only Billing for MDD or EOB Code 2803 - Med D Covered Drug - Bill Medicare First. The claims were reprocessed and appear on the July 11, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or region code 55.
06/23/2017-06/30/2017
Attention Home Health Agencies
Attention Home Health Agencies. PROGRAMMING CHANGE: It has recently come to the Department of Social Services' (DSS) attention that Home Health providers are not always adding all applicable Third Party Liability (TPL) information to claims that would normally cost avoid. DXC Technology has made a recent program change to correct this issue. Home Health Agencies are reminded that when a Connecticut Home Care Program, HUSKY or HUSKY with a waiver client has Medicare and other insurance coverage, and the claim should be cost avoided, providers must add both Medicare and other insurance information on their claim. Claims that are received on or after June 27, 2017 that are not appropriately documented with all applicable Medicare and/or other insurance information will deny for edit 2522 - "Bill Medicare First or Provide Appropriate Adjustment Reason Code and Date of ABN or NOMNC" and/or edit 2504 - "Bill Private Carrier First or invalid adjustment reason code billed". Please Note: Home Health claims submitted via EVV are excluded from edit 2522 through June 30, 2017 to provide time for Agencies to enter Medicare information utilizing the new ABN solution for claims submitted July 1, 2017 and forward.
06/23/2017-06/30/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. WHO TO CONTACT WITH EVV RELATED QUESTIONS: Providers required to use the Santrax system for Electronic Visit Verification (EVV) mandated clients may have questions about who to contact regarding EVV related issues. If you are unsure who to contact, please send an e-mail to ctevv@dxc.com. Important: Do not email client identifying data unless you encrypt your e-mail. If you are missing a client from your Santrax system or have clients that you are unfamiliar with, please send an encrypted email to ctevv@dxc.com. If a prior authorization (PA) is present on the www.ctdssmap.com portal but is not present in the Santrax system, please send an e-mail to ctevv@dxc.com. Please contact Sandata Customer Care if you are experiencing issues with the Santrax system and its functionality. They can be reached at 1-855-399-8050 or by email at ctcustomercare@sandata.com. Please only contact a client's access agency if a PA is either not present or is incorrect on the www.ctdssmap.com portal, or if the client's address has changed and needs to be updated.
06/23/2017-06/30/2017
Attention PCMH Primary Care Providers
Attention 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 27, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/23/2017-06/30/2017
Attention Select Providers
Attention 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 27, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/23/2017-06/30/2017
Attention Primary Care Providers
Attention 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 27, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
06/09/2017-06/16/2017
Attention Home Health Providers
Attention Home Health Providers. REPROCESSED THIS CYCLE: DXC Technology has identified a claims processing issue where the 9% cost share was being taken from Connecticut Home Care claims billed with procedure code G0162. DXC has identified and reprocessed the claims. These claims will appear on the providers June 13, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 50.
06/09/2017-06/16/2017
Attention All Providers
Attention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID 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 13, 2017 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 13, 2017 RA with an ICN beginning with region code 27 if the original claim was submitted electronically, or a region code 15 if the original claim was submitted on paper. Additionally, a number of claims reprocessed in the previous financial cycle to reflect the client's true (permanent) 9 digit CMAP ID when they should not have. These claims were inadvertently reprocessed again in the current financial cycle. These claims have denied as duplicates and posted EOB 5001 since the original payments appeared on the May 23, 2017 RA.
06/09/2017-06/16/2017
Attention Provider
Attention Provider. REPROCESSED THIS CYCLE: DXC Technology has identified a claims processing issue where, if multiple Prior Authorizations (PAs) existed for different services, claims were using and decrementing units from the incorrect PA. The issue impacted claims for dates of service between May 5, 2016 and March 1, 2017. DXC Technology has corrected the issue and reprocessed the impacted claims to use the correct PA. If no PA existed for the service submitted on the claim, the claim is now denying correctly for Explanation of Benefit (EOB) code 3003 "Prior Authorization is Required for the Payment of this Service". The reprocessed claims will appear on your June 13, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 52.
06/09/2017-06/16/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. WHO TO CONTACT WITH EVV RELATED QUESTIONS: Providers required to use the Santrax system for Electronic Visit Verification (EVV) mandated clients may have questions about who to contact regarding EVV related issues. If you are missing a client from your Santrax system or have clients that you are unfamiliar with, please send a secure email to ctevv@dxc.com. If a prior authorization (PA) is present on the www.ctdssmap.com portal but is not present in the Santrax system, please send an email to ctevv@dxc.com. Please contact Sandata Customer Care if you are experiencing issues with the Santrax system and its functionality. They can be reached at 1-855-399-8050 or by email at ctcustomercare@sandata.com. Please only contact a client's access agency if a PA is either not present or incorrect in the www.ctdssmap.com portal, or if the client's address has changed and needs to be updated.
06/09/2017-06/16/2017
Attention All Providers
Attention 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 13, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
05/26/2017-06/02/2017
Attention Department of Developmental Services (DDS) Provider
Attention Department of Developmental Services (DDS) Provider. SPECIAL CLAIMS PROCESSING CYCLE: The Department of Social Services (DSS) has directed DXC Technology to run a special claims processing cycle on May 26, 2017. This cycle will include the rate mass adjustment of DDS claims impacted by a retroactive rate change currently on file for the dates of service of the impacted claims. The reprocessed claims will appear on your May 30, 2017 Remittance Advice with an Internal Control Number (ICN) beginning with a region code 55.
05/19/2017-05/25/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. WHO TO CONTACT WITH EVV RELATED QUESTIONS: Providers required to use the Santrax system for Electronic Visit Verification (EVV) mandated clients may have questions about who to contact regarding EVV related issues. If you are missing a client from your Santrax system or have clients that you are unfamiliar with, please send a secure email to ctevv@dxc.com. If a prior authorization (PA) is present on the www.ctdssmap.com portal but is not present in the Santrax system, please send an email to ctevv@dxc.com. Please contact Sandata Customer Care if you are experiencing issues with the Santrax system and its functionality. They can be reached at 1-855-399-8050 or by email at ctcustomercare@sandata.com. Please only contact a client's access agency if a PA is either not present or incorrect in the www.ctdssmap.com portal, or if the client's telephone number or address changes and needs to be updated.
05/19/2017-05/25/2017
Attention Select Providers
Attention Select Providers. MAY 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 23, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
05/19/2017-05/25/2017
Attention Home Health Providers
Attention Home Health Providers. IMPORTANT NOTIFICATION TO HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after April 3, 2017, all Home Health Providers who service ABI, CHC and PCA waiver clients must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for EVV mandated services not submitted via the EVV system for dates of service April 3, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Electronic Visit Verification Implementation" Important Message on the Home page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services.
05/11/2017-05/18/2017
Attention Department of Developmental Services (DDS) Providers
Attention Department of Developmental Services (DDS) Providers. SPECIAL CLAIMS PROCESSING CYCLE: The Department of Social Services (DSS) has directed DXC Technology to run a special claims processing cycle on May 11, 2017. This cycle will include the rate mass adjustment of DDS claims impacted by a retroactive rate change currently on file for the dates of service of the impacted claims. The reprocessed claims will appear on your May 16, 2017 Remittance Advice with an Internal Control Number (ICN) beginning with a region code 55.
05/05/2017-05/10/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. WHO TO CONTACT WITH EVV RELATED QUESTIONS: Providers required to use the Santrax system for Electronic Visit Verification (EVV) mandated clients may have questions about who to contact regarding EVV related issues. If you are missing a client from your Santrax system or have clients that you are unfamiliar with, please send a secure email to ctevv@dxc.com. If a prior authorization (PA) is present on the www.ctdssmap.com portal but is not present in the Santrax system, please send an email to ctevv@dxc.com. Please contact Sandata Customer Care if you are experiencing issues with the Santrax system and its functionality. They can be reached at 1-855-399-8050 or by email at ctcustomercare@sandata.com. Please only contact a client's access agency if a PA is either not present or incorrect in the www.ctdssmap.com portal, or if the client's telephone number or address changes and needs to be updated.
05/05/2017-05/10/2017
Attention All Providers
Attention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID 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 5, 2017 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 9, 2017 RA with an ICN beginning with region code 27 if the original claim was submitted electronically, or a region code 15 if the original claim was submitted on paper.
05/05/2017-05/10/2017
Attention Home Health Providers
Attention Home Health Providers. IMPORTANT NOTIFICATION TO HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after April 3, 2017, all Home Health Providers who service ABI, CHC and PCA waiver clients must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for EVV mandated services not submitted via the EVV system for dates of service April 3, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Electronic Visit Verification Implementation" Important Message on the Home page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services.
05/05/2017-05/10/2017
Attention All Providers
Attention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims from fiscal year 2016 , quarter 2, that needed to be reprocessed for financial reporting purposes. The reprocessed claims will appear on your May 9, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
04/21/2017-04/28/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. WHO TO CONTACT WITH EVV RELATED QUESTIONS: Providers required to use the Santrax system for Electronic Visit Verification (EVV) mandated clients may have questions about who to contact regarding EVV related issues. If you are missing a client from your Santrax system or have clients that you are unfamiliar with, please send a secure email to ctevv@dxc.com. If a prior authorization (PA) is present on the www.ctdssmap.com portal but is not present in the Santrax system, please send an email to ctevv@dxc.com. Please contact Sandata Customer Care if you are experiencing issues with the Santrax system and its functionality. They can be reached at 1-855-399-8050 or by email at ctcustomercare@sandata.com. Please only contact a client's access agency if a PA is either not present or incorrect in the www.ctdssmap.com portal, or if the client's telephone number or address changes and needs to be updated.
04/21/2017-04/28/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. IMPORTANT NOTIFICATION TO ABI, CHC, PCA, AND HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Providers using the Santrax system now receive an alert notifying them that a Prior Authorization (PA) has been uploaded and/or modified in the Santrax system. These alerts are a one-time popup that appear in the affected client's record in the "Authorizations" tab, but can be viewed, as needed, in the "Changed Authorization Report" found in the Reports section of the Santrax system. The "Changed Authorization Report" provides a complete list of authorizations by date range.
04/21/2017-04/28/2017
Attention Home Health Providers
Attention Home Health Providers. IMPORTANT NOTIFICATION TO HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after April 3, 2017, all Home Health Providers who service ABI, CHC and PCA waiver clients must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for EVV mandated services not submitted via the EVV system for dates of service April 3, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Electronic Visit Verification Implementation" Important Message on the Home page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services.
04/07/2017-04/14/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. IMPORTANT NOTIFICATION TO ABI, CHC, PCA, AND HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Providers using the Santrax system now receive an alert notifying them that a Prior Authorization (PA) has been uploaded and/or modified in the Santrax system. These alerts are a one-time popup that appear in the affected client's record in the "Authorizations" tab, but can be viewed, as needed, in the "Changed Authorization Report" found in the Reports section of the Santrax system. The "Changed Authorization Report" provides a complete list of authorizations by date range.
04/07/2017-04/14/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. WHO TO CONTACT WITH EVV RELATED QUESTIONS: Providers required to use the Santrax system for Electronic Visit Verification (EVV) mandated clients may have questions about who to contact regarding EVV related issues. If you are missing a client from your Santrax system or have clients that you are unfamiliar with, please send a secure email to ctevv@dxc.com. If a prior authorization (PA) is present on the www.ctdssmap.com portal but is not present in the Santrax system, please send an email to ctevv@dxc.com. Please contact Sandata Customer Care if you are experiencing issues with the Santrax system and its functionality. They can be reached at 1-855-399-8050 or by email at ctcustomercare@sandata.com. Please only contact a client's access agency if a PA is either not present or incorrect in the www.ctdssmap.com portal, or if the client's telephone number or address changes and needs to be updated.
04/07/2017-04/14/2017
Attention Home Health Providers
Attention Home Health Providers. IMPORTANT NOTIFICATION TO HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after April 3, 2017, all Home Health Providers who service ABI, CHC and PCA waiver clients must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for EVV mandated services not submitted via the EVV system for dates of service April 3, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Electronic Visit Verification Implementation" Important Message on the Home page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services.
04/07/2017-04/14/2017
Attention Inpatient Hospitals
Attention Inpatient Hospitals. REPROCESSED THIS CYCLE: Inpatient Rehab and Behavioral Health claims that pay at the per diem rate should only pay up to the header billed amount. DXC Technology has identified and reprocessed the Inpatient Rehab and Behavioral Health claims that allowed more than the billed charges and adjusted them to pay up to billed charges. These adjusted claims will appear on the April 11, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 50.
04/07/2017-04/14/2017
Attention All Providers
Attention All Providers. HEWLETT PACKARD ENTERPRISE BECOMES DXC TECHNOLOGY: On April 3, 2017, Hewlett Packard Enterprise (HPE) split and merged with Computer Sciences Corporation (DSC) to form a new company, DXC Technology. Providers will notice the following changes: - Providers will begin to see the DXC Technology logo or the DXC Technology name on correspondence. - Providers will begin to receive emails from the @dxc.com email address rather than the @hpe.com email address. - Providers will hear the DXC Technology name when calling the Provider Assistance Center.
04/07/2017-04/14/2017
Attention All Providers
Attention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID 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 11, 2017 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 11, 2017 RA with an ICN beginning with region code 27 if the original claim was submitted electronically, or a region code 15 if the original claim was submitted on paper.
04/07/2017-04/14/2017
Attention All Providers
Attention All Providers. CHANGE TO HUSKYHEALTH WEB SITE URL: Effective immediately, the www.huskyhealth.com Web site URL has changed. If you have saved this URL, you will need to make updates to access the new URL, www.ct.gov/husky. Providers will begin to see this new URL in updated provider manual chapters. There are no changes to the www.huskyhealthct.org URL, which directs providers to Community Health Network of Connecticut's (CHNCT) Web site, the Administrative Services Organization (ASO) for the HUSKY Health Program.
03/24/2017-03/31/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. WHO TO CONTACT WITH EVV RELATED QUESTIONS: Providers required to use the Santrax system for Electronic Visit Verification (EVV) mandated clients may have questions about who to contact regarding EVV related issues. If you are missing a client from your Santrax system or have clients that you are unfamiliar with, please send a secure email to ctevv@hpe.com. If a prior authorization (PA) is present on the HPE portal but is not present in the Santrax system, please send an email to ctevv@hpe.com. Please contact Sandata Customer Care if you are experiencing issues with the Santrax system and its functionality. They can be reached at 1-855-399-8050 or by email at ctcustomercare@sandata.com. Please only contact a client's access agency if a PA is either not present or incorrect in the HPE portal, or if the client's telephone number or address changes and needs to be updated.
03/24/2017-03/31/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. IMPORTANT NOTIFICATION TO ABI, CHC, PCA, AND HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: As of January 13, 2017, providers using the Santrax system now receive an alert notifying them that a Prior Authorization (PA) has been uploaded and/or modified in the Santrax system. These alerts are a one-time popup that appear in the affected client's record in the "Authorizations" tab, but can be viewed, as needed, in the "Changed Authorization Report" found in the Reports section of the Santrax system. The "Changed Authorization Report" provides a complete list of authorizations by date range.
03/24/2017-03/31/2017
Attention Primary Care Providers
Attention Primary Care Providers. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise 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 28, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
03/24/2017-03/31/2017
Attention PCMH Primary Care Providers
Attention 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 28, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/24/2017-03/31/2017
Attention Dental Providers
Attention Dental Providers. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise has identified an issue where claims for restoration procedure codes (D2140 - D2394) for adult clients that posted the Explanation of Benefit (EOB) Code 9992 "Payment Amount Reflects Tooth Surface Pricing" for dates of service September 1, 2016 forward paid an incorrect amount based off of the Dental Pediatric fee schedule. These claims have been reprocessed to pay the correct Dental Adult fee schedule amount and will appear on your March 28, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
03/24/2017-03/31/2017
Attention All Providers
Attention All Providers. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise has identified and reprocessed claims from 2014 that needed to be reprocessed for financial reporting purposes. The reprocessed claims will appear on your March 28, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
03/24/2017-03/31/2017
Attention Home Health Service Providers
Attention Home Health Service Providers. IMPORTANT NOTIFICATION TO HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after April 3, 2017, all Home Health Providers who service ABI, CHC, and PCA waiver clients must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing mandated services to ABI, CHC, and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for EVV mandated services not submitted via the EVV system for dates of service April 3, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Welcome to the Connecticut Medical Assistance Program Electronic Visit Verification Implementation Important Message" on the Home page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services being provided in Chapter 8 of the Waiver Programs and Special Services provider manual.
03/24/2017-03/31/2017
Attention Select Providers
Attention Select Providers. MARCH 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 28, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/10/2017-03/17/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. IMPORTANT NOTIFICATION TO ABI, CHC, PCA, AND HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: As of January 13, 2017, providers using the Santrax system now receive an alert notifying them that a Prior Authorization (PA) has been uploaded and/or modified in the Santrax system. These alerts are a one-time popup that appear in the affected client's record in the "Authorizations" tab, but can be viewed, as needed, in the "Changed Authorization Report" found in the Reports section of the Santrax system. The "Changed Authorization Report" provides a complete list of authorizations by date range.
03/10/2017-03/17/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. WHO TO CONTACT WITH EVV RELATED QUESTIONS: Providers required to use the Santrax system for Electronic Visit Verification (EVV) mandated clients may have questions about who to contact regarding EVV related issues. If you are missing a client from your Santrax system or have clients that you are unfamiliar with, please send a secure email to ctevv@hpe.com. If a prior authorization (PA) is present on the HPE portal but is not present in the Santrax system, please send an email to ctevv@hpe.com . Please contact Sandata Customer Care if you are experiencing issues with the Santrax system and its functionality. They can be reached at 1-855-399-8050 or by email at ctcustomercare@sandata.com. Please only contact a client's access agency if a PA is either not present or incorrect in the HPE portal, or if the client's telephone number or address changes and needs to be updated.
03/10/2017-03/17/2017
Attention Select Hospice Providers
Attention Select Hospice Providers. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise has reprocessed previously paid claims that were received on or after January 31, 2017 that had payments reduced by 2 percent due to the non-compliant Hospice Rate Reduction. Originally, adjustments were going to occur for previously paid claims with dates of service October 1, 2016 and forward for claims containing revenue center codes (RCCs) 651, 652, 655 and/or 656. Instead, the Department of Social Services (DSS) has overturned their decision to reprocess claims and/or reduce payment for new day claims at this time. Previously paid claims that have been reduced have been reprocessed and will appear on your March 14, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 52.
03/10/2017-03/17/2017
Attention Inpatient Hospitals
Attention Inpatient Hospitals. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise had identified an issue with inpatient rehab claims that denied due to Explanation of Benefit (EOB) code 3004 "Inpatient Claim Requires Prior Authorization" even though there was a rehab PA on file from CHN. Hewlett Packard Enterprise updated their system and inpatient rehab claims will begin to process correctly. Hewlett Packard Enterprise has identified all inpatient claims that denied with dates of service April 1, 2015 and forward and they were reprocessed in the first cycle in March. The re-processed claims will appear on the March 14, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 27.
03/10/2017-03/17/2017
Attention All Providers
Attention All Providers. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise 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 14, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
03/10/2017-03/17/2017
Attention Home Health Service Providers
Attention Home Health Service Providers. IMPORTANT NOTIFICATION TO HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after April 1, 2017, all Home Health Providers who service ABI, CHC and PCA waiver clients must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for EVV mandated services not submitted via the EVV system for dates of service April 1, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Welcome to the Connecticut Medical Assistance Program Electronic Visit Verification Implementation Important Message" on the Home page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services being provided in Chapter 8 of the Waiver Programs and Special Services provider manual.
03/10/2017-03/17/2017
Attention All Providers
Attention All Providers. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise has identified and reprocessed claims which initially processed and paid under a temporary client ID 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 14, 2017 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 14, 2017 RA with an ICN beginning with region code 27 if the original claim was submitted electronically, or a region code 15 if the original claim was submitted on paper.
02/17/2017-02/24/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. IMPORTANT NOTIFICATION TO ABI, CHC, PCA, AND HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: As of January 13, 2017, providers using the Santrax system now receive an alert notifying them that a Prior Authorization (PA) has been uploaded and/or modified in the Santrax system. These alerts are a one-time popup that appear in the affected client's record in the "Authorizations" tab, but can be viewed, as needed, in the "Changed Authorization Report" found in the Reports section of the Santrax system. The "Changed Authorization Report" provides a complete list of authorizations by date range.
02/17/2017-02/24/2017
Attention Select Providers
Attention Select Providers. REPROCESSED THIS CYCLE: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates, or were approved for changes in PCMH level with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level 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 22, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
02/17/2017-02/24/2017
Attention Home Health Service Providers
Attention Home Health Service Providers. IMPORTANT NOTIFICATION TO HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after April 1, 2017, all Home Health Providers who service ABI, CHC and PCA waiver clients must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for EVV mandated services not submitted via the EVV system for dates of service April 1, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Welcome to the Connecticut Medical Assistance Program Electronic Visit Verification Implementation Important Message" on the Home page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services being provided in Chapter 8 of the Waiver Programs and Special Services provider manual.
02/03/2017-02/10/2017
Attention All Providers
Attention All Providers. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise has identified and reprocessed claims which initially processed and paid under a temporary client ID 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 7, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefit (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 7, 2017 RA with an ICN beginning with region code 27 if the original claim was submitted electronically, or a region code 15 if the original claim was submitted on paper.
02/03/2017-02/10/2017
Attention Home Health Providers
Attention Home Health Providers. IMPORTANT NOTIFICATION TO HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after April 1, 2017, all Home Health Providers who service ABI, CHC and PCA waiver clients must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for EVV mandated services not submitted via the EVV system for dates of service April 1, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Welcome to the Connecticut Medical Assistance Program Electronic Visit Verification Implementation Important Message" on the Home page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services being provided in Chapter 8 of the Waiver Programs and Special Services provider manual.
02/03/2017-02/10/2017
Attention Electronic Visit Verification (EVV) Claim Submitters of Home Health and Non-Medical ABI, CHC and PCA services
Attention Electronic Visit Verification (EVV) Claim Submitters of Home Health and Non-Medical ABI, CHC and PCA services. CLAIM SUBMISSION REMINDER: Claims submitted through Electronic Visit Verification (EVV) are electronic 837 claim files, which must pass through Hewlett Packard Enterprises' translator to claims processing. If the file is preceded by other much larger files, such as those submitted by a clearinghouse, your file may be substantially delayed in passing through the translator. Providers submitting claims via the EVV system are encouraged not to wait until the cutoff date to submit their claims to avoid the potential of non-payment, due to delay in passing through the translator or file failure during submission. File failure on the cutoff date may not leave sufficient time to troubleshoot the issue, correct and resubmit the file to meet the cutoff time to ensure claims processing in the current financial cycle. Reimbursement of payable claims not received in time for processing in the current financial cycle will be delayed until the following financial cycle.
02/03/2017-02/10/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. IMPORTANT NOTIFICATION TO ABI, CHC, PCA, AND HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective January 13, 2017, providers using the Santrax system will now receive an alert notifying them that a Prior Authorization (PA) has been uploaded and/or modified in the Santrax system. These alerts are a one-time popup that appear in the affected client's record in the "Authorizations" tab, but can be viewed, as needed, in the "Changed Authorization Report" found in the Reports section of the Santrax system. The "Changed Authorization Report" provides a complete list of authorizations by date range.
02/03/2017-02/10/2017
Attention Outpatient Hospitals
Attention Outpatient Hospitals. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise previously identified Medicare HMO laboratory crossover claims that were not considering the Medicare HMO co-pay. Hewlett Packard Enterprise has identified additional claims that should have previously been re-processed retroactive to January 1, 2014. The additional claims have been reprocessed and will appear on your February 7, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 15 if originally paper, or a region code 27 if originally electronic.
02/03/2017-02/10/2017
Attention ABI, CHC and PCA Service Providers
Attention ABI, CHC and PCA Service Providers. IMPORTANT NOTIFICATION TO ABI, CHC AND PCA SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after January 1, 2017, ABI, CHC and PCA Service providers must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing non-medical EVV mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for non-medical EVV mandated services not submitted via the EVV system for dates of service January 1, 2017 and forward are denying with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Welcome to the Connecticut Medical Assistance Program Electronic Visit Verification Implementation Important Message" on the Home page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services being provided in Chapter 8 of the Waiver Programs and Special Services provider manual.
01/20/2017-01/27/2017
Attention Select Providers
Attention Select Providers. REPROCESSED THIS CYCLE: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates, or were approved for changes in PCMH level with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level 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 24, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
01/20/2017-01/27/2017
Attention ABI, CHC, PCA and Home Health Service Providers
Attention ABI, CHC, PCA and Home Health Service Providers. IMPORTANT NOTIFICATION TO ABI, CHC, PCA, AND HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective January 13, 2017, providers using the Santrax system will receive an alert notifying them that a Prior Authorization (PA) has been uploaded and/or modified in the Santrax system. These alerts are a one-time popup that appear in the affected client's record in the "Authorizations" tab, but can be viewed, as needed, in the "Changed Authorization Report" found in the Reports section of the Santrax system. The "Changed Authorization Report" will provide a complete list of authorizations by date range.
01/20/2017-01/27/2017
Attention Home Health Providers
Attention Home Health Providers. IMPORTANT NOTIFICATION TO HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after February 1, 2017, all Home Health Providers who service ABI, CHC and PCA waiver clients must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for EVV mandated services not submitted via the EVV system for dates of service February 1, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Welcome to the Connecticut Medical Assistance Program Electronic Visit Verification Implementation Important Message" on the Home Page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services being provided in Chapter 8 of the Waiver Programs and Special Services provider manual.
01/20/2017-01/27/2017
Attention ABI, CHC and PCA Service Providers
Attention ABI, CHC and PCA Service Providers. IMPORTANT NOTIFICATION TO ABI, CHC AND PCA SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after January 1, 2017, ABI, CHC and PCA Service providers must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing non-medical EVV mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for non-medical EVV mandated services not submitted via the EVV system for dates of service January 1, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claim Must Be Submitted Via EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Welcome to the Connecticut Medical Assistance Program Electronic Visit Verification Implementation Important Message" on the Home Page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services being provided in Chapter 8 of the Waiver Programs and Special Services provider manual.
01/06/2017-01/13/2017
Attention Home Health Providers
Attention Home Health Providers. IMPORTANT NOTIFICATION TO HOME HEALTH SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after February 1, 2017, all Home Health Providers who service ABI, CHC and PCA waiver clients must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for EVV mandated services not submitted via the EVV system for dates of service February 1, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claims Must Be Submitted Via The EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Welcome to the Connecticut Medical Assistance Program Electronic Visit Verification Implementation Important Message" on the Home Page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services being provided in Chapter 8 of the Waiver Programs and Special Services provider manual.
01/06/2017-01/13/2017
Attention ABI, CHC and PCA Service Providers
Attention ABI, CHC and PCA Service Providers. IMPORTANT NOTIFICATION TO ABI, CHC AND PCA SERVICE PROVIDERS OF EVV MANDATED SERVICES: Effective for dates of service on or after January 1, 2017, ABI, CHC and PCA Service providers must utilize the Electronic Visit Verification (EVV) check-in and check-out process when providing non-medical EVV mandated services to ABI, CHC and PCA Waiver clients. EVV services matching the service authorizations for the client must then be submitted via the EVV system. Claims for non-medical EVV mandated services not submitted via the EVV system for dates of service January 1, 2017 and forward will deny with Explanation of Benefits (EOB) code 0630 - "Claims Must Be Submitted Via The EVV System". As a result, providers will not be reimbursed for these services until they are submitted via the EVV system. EVV mandated services may be found on the EVV Service Code list in the "Welcome to the Connecticut Medical Assistance Program Electronic Visit Verification Implementation Important Message" on the Home Page of the www.ctdssmap.com Web site. EVV mandated services may also be found on the Procedure Code Crosswalk for the waiver services being provided in Chapter 8 of the Waiver Programs and Special Services provider manual.
01/06/2017-01/13/2017
Attention Outpatient Hospitals
Attention Outpatient Hospitals. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise has identified and denied outpatient claims that originally processed without a physician Prior Authorization (PA) on file. The impacted outpatient paid claims have been denied with Explanation of Benefits (EOB) code 3013 "Service Requires a Professional Prior Authorization" and will appear on the January 10, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
01/06/2017-01/13/2017
Attention All Providers
Attention All Providers. REPROCESSED THIS CYCLE: Hewlett Packard Enterprise has identified and reprocessed claims which initially processed and paid under a temporary client ID 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 10, 2017 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 10, 2017 RA with an ICN beginning with region code 27 if the original claim was submitted electronically, or a region code 15 if the original claim was submitted on paper.
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