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- 2024 Important Messages Archived
Message Effective DateTitle
03/18/2024-04/14/2024

Hospital Monthly Important Message (Posted 3/18/24)
02/29/2024-04/01/2024

Attention Dental Providers: UPDATED Service Interruption (Posted 2/29/24)
02/23/2024-04/01/2024

Attention Pharmacy Providers: Options for Pharmacies Affected by Optum Change Healthcare (CHC) Network Service Interruption (Posted 2/23/24)
02/21/2024-02/21/2024

Attention Providers and Trading Partners: Telephony Network Service Interruption (Posted 2/22/24)
02/16/2024-03/17/2024

Hospital Monthly Important Message (Posted 2/16/24)
01/18/2024-03/01/2024

Attention Home Health Providers: Electronic Visit Verification (EVV) Updates - as of January 18, 2024 (Posted 1/18/24)
01/12/2024-02/15/2024

Hospital Monthly Important Message (Posted 1/12/24)
01/11/2024-04/01/2024

Attention Home Health Providers: Home Health Authorizations: Upcoming Change (Posted 1/11/24)
01/09/2024-02/28/2024

Attention Home Health Providers: Electronic Visit Verification (EVV) Updates - as of January 9, 2024 (Posted 1/9/24)
01/05/2024-01/31/2024

Attention All Providers: Medicare Part A Crossover Claims (Posted 1/5/24)
  
+ 2023 Important Messages Archived
  
+ 2022 Important Messages Archived
  
+ 2021 Important Messages Archived
  
+ 2020 Important Messages Archived
  
+ 2019 Important Messages Archived
  
+ 2018 Important Messages Archived
  
+ 2017 Important Messages Archived
  
+ 2016 Important Messages Archived
  
+ 2015 Important Messages Archived
  
+ 2014 Important Messages Archived
  
+ 2013 Important Messages Archived
  
- 2024 RA Banner Announcements Archived
Banner Effective DateProvidersBanner Page Announcement
04/05/2024-04/12/2024Attention Select ProvidersAttention Select Providers. EOB 1008 BILLING IN PERFORMING BANNER. A very small sample of your production claims were reviewed. Your organization is currently submitting the billing provider in the performing provider field and your claims are posting EOB 1008. Performing Provider Must Have an Individual Number. Please update claim details by submitting the performing provider who saw the client. Beginning 6/1/2024, claim details without a performing provider will deny and post EOB 1008 will deny. Please review PB24-11 Revised Deadline: Performing Providers Required for Behavioral Health Clinic Providers and make the necessary updates.
04/05/2024-04/12/2024Attention Home Health ProvidersAttention Home Health Providers. All home health providers are reminded that they should now be utilizing Electronic Visit Verification (EVV) to capture Home Health Care Services (HHCS) visit data in accordance with the federal mandate in the 21st Century Cures Act. Effective for dates of service March 22, 2024, through March 31, 2024, providers will see an explanation of benefit (EOB) code post to claims but still pay when a confirmed visit cannot be found or when units are exceeded. Effective for dates of service April 1, 2024, and forward, providers will receive claim denials when a confirmed visit cannot be found or when units are exceeded. Please note that as of April 1, 2024, the following medication administration procedure codes will not be subject to EVV claim editing: T1502, T1503, and H0033. Providers must continue to use EVV to capture visit data for these services. Providers utilizing Sandata Agency Management will be issued step-by-step instructions on how to enter visits for medication administration services that are less than 8 minutes. Claim edit enforcement dates for medication administration procedure codes will be communicated in a future Important Message.
04/05/2024-04/12/2024Attention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service ProvidersAttention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service Providers. REMINDER OF OPTIONAL TRANSITION TO OPEN VENDOR ELECTRONIC VISIT VERIFICATION (EVV) MODEL. In 2016, Section 12006 of the 21st Century Cures Act established a requirement for all states to use an Electronic Visit Verification (EVV) system for Medicaid-funded Personal Care Services (PCS). Currently, the Department of Social Services (DSS) and Department of Mental Health and Addiction Services (DMHAS) utilize a State Mandated External Vendor model for the collection of PCS visit data. All PCS providers are required to submit visit data to the system designed by the State's external EVV vendor (i.e., Sandata Technologies). DSS and DMHAS will be transitioning from a State Mandated External Vendor model to an Open Vendor EVV model with an aggregator solution for PCS. The Open Vendor EVV model will allow providers the opportunity to use either the State's existing external EVV vendor system (i.e., Sandata Agency Management) or their own third-party ("Alternate EVV") system to capture visit data. Changes to accept all PCS visit data from either the State's existing EVV system or an Alternate EVV system are targeted for implementation in May 2024. Additional information, including vendor specifications and upcoming Town Halls, can be found on the www.ctdssmap.com Web site by selecting Information > Publications and performing a search on PB24-22 Open Vendor Electronic Visit Verification (EVV) Model Implementation for Personal Care Services (PCS) - Technical Specification and Town Hall Registration.
04/05/2024-04/12/2024Attention Select ProvidersAttention Select Providers. Mix EOB 1010 Performing not in Group and EOB 1008 Billing in performing banner. A very small sample of your production claims were reviewed. Two Scenarios were identified: Scenario 1 Some of your organization's claims are being submitted with a performing provider. However, the performing provider on the claim is not associated to the billing provider group for the date of service on the claim. With dates of service 6/1/2024, these claim details will post EOB 1010 Performing Provider is Not a Member of the Billing Provider Group and will deny. Please review PB24-11 Revised Deadline: Performing Providers Required for Behavioral Health Clinic Providers and make the necessary updates. Scenario 2 Some of your organization's claims are being submitted with the billing provider in the performing provider field and your claims are posting EOB 1008 Performing Provider Must Have an Individual Number. This can be seen by downloading a copy of your PDF remittance advice. For claim details with dates of service 6/1/2024 forward, claims posting EOB 1008 will deny. Please review PB24-11 Revised Deadline: Performing Providers Required for Behavioral Health Clinic Providers and make the necessary updates.
04/05/2024-04/12/2024Attention Select ProvidersAttention Select Providers. BEHAVIORAL HEALTH ATTESTATION REQUIREMENT FOR BEHAVIORAL HEALTH CLINICIAN GROUPS AND CLINICIANS. DSS requires all Behavioral Health Groups and Providers to complete the Behavioral Health Attestation through their Secure Web Portal. Currently, claims are not denied for not completing the attestation. DSS has extended the time to allow providers to complete this requirement. This requirement was presented in a phased approach beginning July 6th, 2023. Providers have been given a full year to provide sufficient time for your organization to comply. Non-compliance letters will be sent starting August 1st, 2024 in a phased approach to notify providers that their claims will be denied. Please reference PB 2023-56 for detailed instructions. You are receiving this banner message as your organization and performing providers still need to comply with this requirement.
04/05/2024-04/12/2024Attention Select ProvidersAttention Select Providers. PERFORMING PROVIDERS REQUIRED FOR BEHAVIORAL HEALTH CLINIC CLAIMS: Effective with dates of service 6/1/2024, DSS will require all claims to be submitted with an enrolled performing provider's National Provider Identifier (NPI). Currently, claims are not denied for the omission of the performing provider's NPI on Behavioral Health Clinic claims. Please refer to Provider Bulletin 2023-44 issued on June 5, 2023 for full policy. DSS has extended the time to allow providers to enroll performing providers for a full year providing sufficient time for your organization to comply. Claims will begin to deny for claims with dates of service 6/1/2024 forward. You are receiving this banner message as your organization still needs to enroll performing providers. To avoid any service interruption please complete requirement.
04/05/2024-04/12/2024Attention Select ProvidersAttention Select Providers. EOB 231 NOT SUBMITTING PERFORMING BANNER. A very small sample of your production claims were reviewed. Your organization needs to submit the performing provider on each detail of your claim. This is required to prevent upcoming claim denials. Beginning 6/1/2024, claim details without a performing provider will deny and post EOB 231 Performing Provider is Missing. Please review PB24-11 Revised Deadline: Performing Providers Required for Behavioral Health Clinic Providers and make the necessary claim submission updates.
04/05/2024-04/12/2024Attention Select ProvidersAttention Select Providers. Place Of Service 55 Requirement: Based on reviewing your most current remittance advice, your organization still needs to make claim billing changes to utilize place of service (POS) 55 before 4/1/2024. Claims with date of service on or after April 1, 2024 that are billed without POS 55 will deny with Explanation of Benefit (EOB) code 4821 "Facility Type is Restricted for Procedure Under Provider Contract". Please see bulletin PB24-09 Place of Service (POS) Requirements for Substance Use Disorder (SUD) Treatment for further details. NOTE: POS can also be referred to as facility type code (FTC).
04/05/2024-04/12/2024Attention Select ProvidersAttention Select Providers. Mix EOB 1007 Performing Provider not on file and EOB 1008 Billing in performing banner. A very small sample of your production claims were reviewed. Two Scenarios were identified: Scenario 1 When a performing provider is required on the claim, the performing provider must be enrolled with the Connecticut Medical Assistance Program (CMAP), AND be associated with the billing provider group, for dates of service on the claim. Some of your organization's claims are being submitted with a performing provider that is not enrolled in CMAP. These claims will post EOB 1007 Detail rendering (performing) provider identification number is not on file. For claim details with dates of service 6/1/2024 forward, claim details will deny. Please review PB24-11 Revised Deadline: Performing Providers Required for Behavioral Health Clinic Providers and make the necessary updates. Scenario 2 Some of your organization's claims are being submitted with the billing provider in the performing provider field and your claims are posting EOB 1008 Performing Provider Must Have an Individual Number. This can be seen by downloading a copy of your PDF remittance advice. For claim details with dates of service 6/1/2024 forward, claims posting EOB 1008 will deny. Please review PB24-11 Revised Deadline: Performing Providers Required for Behavioral Health Clinic Providers and make the necessary updates.
04/05/2024-04/12/2024Attention Home Health, Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service ProvidersAttention Home Health, Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service Providers. Providers are reminded that Sandata released a new SMC mobile application with enhanced features. All providers must be using the "NEW SMC 2.0" version by June 15, 2024, as the previous application will no longer be supported after June 30, 2024. Please use the following Sandata on Demand (SoD) link to download the SMC 2.0 application as well as review articles (e.g., Introduction, Language Support, Offline Mode) and screenshots of the different application screens (e.g., Visits Screen, Clients Screen, Settings Screen): https://sandata.zendesk.com/hc/en-us/sections/18037326015635- Sandata-Mobile-Connect-SMC-Version-2. Providers are also encouraged to review the SMC 2.0 application video library at the following SoD link: https://sandata.zendesk.com/hc/en-us/articles/21560498569491-- Sandata-Mobile-Connect-2-0-Video-Library.
04/05/2024-04/12/2024Attention Select ProvidersAttention Select Providers. EOB 1010 Banner Performer not associated to Billing Provider Group Banner. In reviewing a very small sample of claims, your claim details are being submitted with a performing provider. However, the performing provider on the claim is not associated to the billing provider group for the date of service on the claim. These claims will post EOB 1010 Performing Provider is Not a Member of the Billing Provider Group for claim details with dates of service 6/1/2024 forward and the claim details will deny. Please review PB24-11 Revised Deadline: Performing Providers Required for Behavioral Health Clinic Providers and make the necessary updates.
04/05/2024-04/12/2024Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the April 10, 2024 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". New claims will also appear on the April 10, 2024 RA with an ICN beginning with region code 27.
04/05/2024-04/12/2024Attention Select ProvidersAttention Select Providers. EOB 231 Mix No performing submitted and EOB 1008 Billing in performing banner. A very small sample of your production claims were reviewed. Two Scenarios were identified: Scenario 1 Some of your organization's claims need to be submitted with the performing provider on each detail of your claim. This is required to prevent upcoming claim denials. Beginning 6/1/2024, claim details without a performing provider will deny and post EOB 231 Performing Provider is Missing. Scenario 2 Some of your organization's claims are being submitted with the billing provider in the performing provider field and your claims are posting EOB 1008 Performing Provider Must Have an Individual Number. This can be seen by downloading a copy of your PDF remittance advice. For claim details with dates of service 6/1/2024 forward, claims posting EOB 1008 will deny. Please review PB24-11 Revised Deadline: Performing Providers Required for Behavioral Health Clinic Providers and make the necessary updates.
03/22/2024-03/29/2024Attention All ProvidersAttention All Providers. HOLIDAY CLOSURE: Please be advised, the Department of Social Services (DSS) and Gainwell Technologies will be closed on Friday, March 29, 2024 in observance of the Good Friday holiday. Both the DSS and Gainwell Technologies offices will re-open on Monday, April 1, 2024.
03/22/2024-03/29/2024Attention All ProvidersAttention All Providers. PROVIDER FILE MAINTENANCE: In order to maintain the accuracy and completeness of the Connecticut Medical Assistance Program (CMAP) network, we are requesting all providers update their provider file on a regular basis. The information that you provide is presented in the on-line provider directory at www.ct.gov/husky. Thousands of members statewide rely on the accuracy of this source of information to find a suitable health care provider. Inaccurate addresses, phone numbers, and names may affect a member's ability to contact you. To update your provider profile, the main account administrator can log into their secure Web account from the www.ctdssmap.comWeb site and click on the "Demographic Maintenance" tab. Once on the Demographic Maintenance page, the provider can select from options listed as links below the Demographic Maintenance header panel. For instance, you can update your address* if you happen to move to a new location; all you have to do is click on the "Location Name Address" link, select the address to be updated, click on the "Maintain Address" button to type in the new address and then save your changes. You can also add or remove performing providers to your group practice as applicable by clicking on "Maintain Organization Members". For detailed instructions, please refer to Section 10.18 "Provider Demographic Maintenance" in Chapter 10 of the Provider Manual. The chapter is available from the Web site www.ctdssmap.comby clicking on "Publications" under Information, scrolling down to Provider Manuals and then clicking on "Web Portal/AVRS". Providers may contact the Provider Assistance Center at 1-800-842-8440 between the hours of 8:00 AM to 5:00 PM Monday through Friday if further assistance is needed in updating the information from their secure Web portal account. *There are special instructions for PCMH providers and licensed facilities such as hospitals, pharmacies, and clinic providers for updating their service location or alternate service location addresses. Please refer to the warning messages on the Web pages, as well as Chapter 10 for additional information.
03/22/2024-03/29/2024Attention Home Health ProvidersAttention Home Health Providers. All home health providers are reminded that they should now be utilizing Electronic Visit Verification (EVV) to capture Home Health Care Services (HHCS) visit data in accordance with the federal mandate in the 21st Century Cures Act. Effective for dates of service March 22, 2024, through March 31, 2024, providers will see an explanation of benefit (EOB) code post to claims but still pay when a confirmed visit cannot be found or when units are exceeded. Effective for dates of service April 1, 2024, and forward, providers will receive claim denials when a confirmed visit cannot be found or when units are exceeded. Please note that as of April 1, 2024, the following medication administration procedure codes will not be subject to EVV claim editing: T1502, T1503, and H0033. Providers must continue to use EVV to capture visit data for these services. Providers utilizing Sandata Agency Management will be issued step-by-step instructions on how to enter visits for medication administration services that are less than 8 minutes. Claim edit enforcement dates for medication administration procedure codes will be communicated in a future Important Message.
03/22/2024-03/29/2024Attention Home Health, Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service ProvidersAttention Home Health, Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service Providers. Providers are reminded that Sandata released a new SMC mobile application with enhanced features. All providers must be using the "NEW SMC 2.0" version by June 15, 2024, as the previous application will no longer be supported after June 30, 2024. Please use the following Sandata on Demand (SoD) link to download the SMC 2.0 application as well as review articles (e.g., Introduction, Language Support, Offline Mode) and screenshots of the different application screens (e.g., Visits Screen, Clients Screen, Settings Screen): https://sandata.zendesk.com/hc/en-us/sections/18037326015635- Sandata-Mobile-Connect-SMC-Version-2. Providers are also encouraged to review the SMC 2.0 application video library at the following SoD link: https://sandata.zendesk.com/hc/en-us/articles/21560498569491-- Sandata-Mobile-Connect-2-0-Video-Library.
03/22/2024-03/29/2024Attention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service ProvidersAttention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service Providers. REMINDER OF OPTIONAL TRANSITION TO OPEN VENDOR ELECTRONIC VISIT VERIFICATION (EVV) MODEL. In 2016, Section 12006 of the 21st Century Cures Act established a requirement for all states to use an Electronic Visit Verification (EVV) system for Medicaid-funded Personal Care Services (PCS). Currently, the Department of Social Services (DSS) and Department of Mental Health and Addiction Services (DMHAS) utilize a State Mandated External Vendor model for the collection of PCS visit data. All PCS providers are required to submit visit data to the system designed by the State's external EVV vendor (i.e., Sandata Technologies). DSS and DMHAS will be transitioning from a State Mandated External Vendor model to an Open Vendor EVV model with an aggregator solution for PCS. The Open Vendor EVV model will allow providers the opportunity to use either the State's existing external EVV vendor system (i.e., Sandata Agency Management) or their own third-party ("Alternate EVV") system to capture visit data. Changes to accept all PCS visit data from either the State's existing EVV system or an Alternate EVV system are targeted for implementation in May 2024. Additional information, including vendor specifications and upcoming Town Halls, can be found on the www.ctdssmap.com Web site by selecting Information > Publications and performing a search on PB24-22 Open Vendor Electronic Visit Verification (EVV) Model Implementation for Personal Care Services (PCS) - Technical Specification and Town Hall Registration.
03/22/2024-03/29/2024Attention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism Waiver Service and Support and Planning Coach ProvidersAttention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism Waiver Service and Support and Planning Coach Providers. Credentialing Update - New Fiscal Intermediary (FI) GT Independence. Providers working on credentialing through Allied Community Resources should continue to do so until March 24, 2024. Autism Waiver Service providers previously credentialed by the Department of Social Services (DSS) Community Options unit, will transition to GT Independence when renewing their credentials prior to their next reenrollment period. More information on credentialing, including an updated credentialing process will be coming soon. The current credentialing process will continue, until more information is made available.
03/22/2024-03/29/2024Attention Select ProvidersAttention Select 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 27, 2024 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/22/2024-03/29/2024Attention 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 27, 2024 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/22/2024-03/29/2024Attention Performing Providers Required for Behavioral Health Clinic ClaimsAttention Performing Providers Required for Behavioral Health Clinic Claims. DSS will require all claims to be submitted with an enrolled performing provider's National Provider Identifier (NPI). Currently, claims are not denied for the omission of the performing provider's NPI on Behavioral Health Clinic claims. Please refer to Provider Bulletin 2023-44 issued on June 5, 2023 for full policy. DSS has extended the time to allow providers to enroll performing providers for a full year providing sufficient time for your organization to comply. Claims will begin to deny for claims with dates of service 6/1/2024 forward. You are receiving this banner message as your organization still needs to enroll performing providers. Your ID indicates claim activity in 2024. To avoid any service interruption please complete requirement.
03/22/2024-03/29/2024Attention Primary Care ProvidersAttention Primary Care Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims for providers who were retroactively approved for the HUSKY Health Primary Care Increased Payments policy. The reprocessed claims will appear on your March 27, 2024 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52.
03/22/2024-03/29/2024Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed Professional and Professional Crossover claims that incorrectly paid at the Default (DEF) rate instead of the Facility (FTD) rate for procedure code 99152, when billed with a facility place of service of 19,21,22,23,24,25,31 or 32. The reprocessed claims will appear on the March 27, 2024 Remittance Advice (RA) with an ICN beginning with region code 52.
03/22/2024-03/29/2024Attention Select ProvidersAttention Select Providers. Place Of Service 55 Requirement: Based on reviewing your most current remittance advice, your organization still needs to make a claims billing changes to utilize place of service (POS) 55 before 4/1/2024. Claims with date of service on or after April 1, 2024 that are billed without POS 55 will deny with Explanation of Benefit (EOB) code 4821 "Facility Type is Restricted for Procedure Under Provider Contract". Please see bulletin PB24-09 Place of Service (POS) Requirements for Substance Use Disorder (SUD) Treatment for further details. NOTE: POS can also be referred to as facility type code (FTC).
03/08/2024-03/15/2024Attention Select ProvidersAttention Select Providers. PERFORMING PROVIDERS REQUIRED FOR BEHAVIORAL HEALTH CLINIC CLAIMS: DSS will require all claims to be submitted with an enrolled performing provider's National Provider Identifier (NPI). Currently, claims are not denied for the omission of the performing provider's NPI on Behavioral Health Clinic claims. Please refer to Provider Bulletin 2023-44 issued on June 5, 2023 for full policy. DSS has extended the time to allow providers to enroll performing providers for a full year providing sufficient time for your organization to comply. Claims will begin to deny for claims with dates of service 6/1/2024 forward. You are receiving this banner message as your organization still needs to enroll performing providers. Your ID indicates claim activity in 2024. To avoid any service interruption please complete requirement.
03/08/2024-03/15/2024Attention Select ProvidersAttention Select Providers. PERFORMING PROVIDERS REQUIRED FOR BEHAVIORAL HEALTH CLINIC CLAIMS: DSS will require all claims to be submitted with an enrolled performing provider's National Provider Identifier (NPI). Currently, claims are not denied for the omission of the performing provider's NPI on Behavioral Health Clinic claims. Please refer to Provider Bulletin 2023-44 issued on June 5, 2023 for full policy. DSS has extended the time to allow providers to enroll performing providers for a full year providing sufficient time for your organization to comply. Claims will begin to deny for claims with dates of service 6/1/2024 forward. You are receiving this banner message as your organization still needs to enroll performing providers.
03/08/2024-03/15/2024Attention Select ProvidersAttention Select Providers. Place Of Service 55 Requirement: Based on reviewing your most current remittance advice, your organization still needs to make a claims billing changes to utilize place of service (POS) 55 before 4/1/2024. Claims with date of service on or after April 1, 2024 that are billed without POS 55 will deny with Explanation of Benefit (EOB) code 4821 "Facility Type is Restricted for Procedure Under Provider Contract". Please see bulletin PB24-09 Place of Service (POS) Requirements for Substance Use Disorder (SUD) Treatment for further details. NOTE: POS can also be referred to as facility type code (FTC).
03/08/2024-03/15/2024Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the March 13, 2024 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". New claims will also appear on the March 13, 2024 RA with an ICN beginning with region code 27.
03/08/2024-03/15/2024Attention Pharmacy ProvidersAttention Pharmacy Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially paid and posted one of the following informational Ordering, Prescribing, Referring (OPR) Explanation of Benefit (EOB) codes, but for which the provider in question has since successfully enrolled in the Connecticut Medical Assistance Program (CMAP): EOB Code 0237-PRESCRIBING PROVIDER IS A STUDENT OR RESIDENT AND MUST BE ENROLLED TO PRESCRIBE EOB Code 0027-CLAIM BYPASSED EDIT 0207 DUE TO PPE AUTO-PA EOB Code 0207-PRESCRIBER NOT ENROLLED EOB Code 0028-PRESCRIBING PROVIDER IN PROCESS OF ENROLLING EOB Code 1040-ORDERING/REFERRING/ATTENDING PROVIDER IS NOT ENROLLED ON DATE OF SERVICE These claims will appear on the March 13, 2024 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
03/08/2024-03/15/2024Attention Home Health ProvidersAttention Home Health Providers. Home health providers must prioritize onboarding and submission of Electronic Visit Verification (EVV) production data for all Home Health Care Services (HHCS) either via the State's EVV system (i.e., Sandata Agency Management) or an Alternate EVV solution. Moreover, home health claims without a confirmed visit will result in a payment denial for dates of service effective April 1, 2024, and forward. Furthermore, the following trainings have been conducted regarding utilization of Sandata Agency Management to capture home health visit data: a DELTA training geared towards home health providers currently using Sandata Agency Management; and a series of training sessions for new Sandata Agency Management users. The recordings are available for review on the Sandata on Demand (SoD) Web site for those who were unable to attend the trainings. To access the recordings and other helpful information on the SoD Web site, please log into your account on Sandata Technologies (sandata.zendesk.com), click Payer Programs, followed by Connecticut (CT DSS, DDS, MHW), and then Connecticut Instructional Videos. The DELTA training recording is available under the Connecticut Home Health Non-Waiver Delta Training Sessions tab. The training recordings for new Sandata Agency Management users are accessible under the Connecticut Home Health Non-Waiver Training Sessions 2023 tab. For providers using the Sandata Agency Management system, training is required to receive the EVV Welcome Kit. As for providers utilizing an Alternate EVV solution, Sandata self-paced online aggregator training must be completed once providers have received their EVV production credentials.
03/08/2024-03/15/2024Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed under the COVID benefit plan as described in Provider Bulletin 2020-42. The claims were reprocessed to reflect the client's retroactive benefit plan change to one of the HUSKY benefit plans. The reprocessed claims will appear on the March 13, 2024 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
02/23/2024-03/01/2024Attention Home Health ProvidersAttention Home Health Providers. Home health providers must prioritize onboarding and submission of Electronic Visit Verification (EVV) production data for all Home Health Care Services (HHCS) either via the State's EVV system (i.e., Sandata Agency Management) or an Alternate EVV solution. Moreover, home health claims without a confirmed visit will result in a payment denial for dates of service effective April 1, 2024, and forward. Furthermore, the following trainings have been conducted regarding utilization of Sandata Agency Management to capture home health visit data: a DELTA training geared towards home health providers currently using Sandata Agency Management; and a series of training sessions for new Sandata Agency Management users. The recordings are available for review on the Sandata on Demand (SoD) Web site for those who were unable to attend the trainings. To access the recordings and other helpful information on the SoD Web site, please log into your account on Sandata Technologies (sandata.zendesk.com), click Payer Programs, followed by Connecticut (CT DSS, DDS, MHW), and then Connecticut Instructional Videos. The DELTA training recording is available under the Connecticut Home Health Non-Waiver Delta Training Sessions tab. The training recordings for new Sandata Agency Management users are accessible under the Connecticut Home Health Non-Waiver Training Sessions 2023 tab. For providers using the Sandata Agency Management system, training is required to receive the EVV Welcome Kit. As for providers utilizing an Alternate EVV solution, Sandata self-paced online aggregator training must be completed once providers have received their EVV production credentials.
02/23/2024-03/01/2024Attention All ProvidersAttention All Providers. PROVIDER FILE MAINTENANCE: In order to maintain the accuracy and completeness of the Connecticut Medical Assistance Program (CMAP) network, we are requesting all providers update their provider file on a regular basis. The information that you provide is presented in the on-line provider directory at www.ct.gov/husky. Thousands of members statewide rely on the accuracy of this source of information to find a suitable health care provider. Inaccurate addresses, phone numbers, and names may affect a member's ability to contact you. To update your provider profile, the main account administrator can log into their secure Web account from the www.ctdssmap.com Web site and click on the "Demographic Maintenance" tab. Once on the Demographic Maintenance page, the provider can select from options listed as links below the Demographic Maintenance header panel. For instance, you can update your address* if you happen to move to a new location; all you have to do is click on the "Location Name Address" link, select the address to be updated, click on the "Maintain Address" button to type in the new address and then save your changes. You can also add or remove performing providers to your group practice as applicable by clicking on "Maintain Organization Members". For detailed instructions, please refer to Section 10.18 "Provider Demographic Maintenance" in Chapter 10 of the Provider Manual. The chapter is available from the Web site www.ctdssmap.com by clicking on "Publications" under Information, scrolling down to Provider Manuals and then clicking on "Web Portal/AVRS". Providers may contact the Provider Assistance Center at 1-800-842-8440 between the hours of 8:00 AM to 5:00 PM Monday through Friday if further assistance is needed in updating the information from their secure Web portal account. *There are special instructions for PCMH providers and licensed facilities such as hospitals, pharmacies, and clinic providers for updating their service location or alternate service location addresses. Please refer to the warning messages on the Web pages, as well as Chapter 10 for additional information.
02/23/2024-03/01/2024Attention Select ProvidersAttention Select Providers. PERFORMING PROVIDERS REQUIRED FOR BEHAVIORAL HEALTH CLINIC CLAIMS: DSS will require all claims to be submitted with an enrolled performing provider's National Provider Identifier (NPI). Currently, claims are not denied for the omission of the performing provider's NPI on Behavioral Health Clinic claims. Please refer to Provider Bulletin 2023-44 issued on June 5, 2023 for full policy. DSS has extended the time to allow providers to enroll performing providers for a full year providing sufficient time for your organization to comply. Claims will begin to deny for claims with dates of service 6/1/2024 forward. You are receiving this banner message as your organization still needs to enroll performing providers.
02/23/2024-03/01/2024Attention Outpatient Hospital ProvidersAttention Outpatient Hospital Providers. REPROCESSED THIS CYCLE: DSS and Gainwell Technologies have identified and reprocessed Outpatient Hospital claims where the claim set edit 334 because the grouper did not assign a status indicator. The grouper did not assign the status indicator because changes that were required to support assigning the status indicator were not in place at the start of the quarter. These claims have been reprocessed and will appear on the February 27, 2024 Remittance Advice (RA) with an internal control Number (ICN) beginning with region code 52.
02/23/2024-03/01/2024Attention Select Dental ProvidersAttention Select Dental Providers. REPROCESSED THIS CYCLE: DSS and Gainwell Technologies have identified and reprocessed Dental claims with procedure code D2991 that processed between 1/1/2024 and 2/13/2024. These claims have been reprocessed and will appear on the February 27, 2024 Remittance Advice (RA) with an internal control Number (ICN) beginning with region code 50.
02/09/2024-02/16/2024Attention Home Health ProvidersAttention Home Health Providers. Home health providers must prioritize onboarding and submission of Electronic Visit Verification (EVV) production data for all Home Health Care Services (HHCS) either via the State's EVV system (i.e., Sandata Agency Management) or an Alternate EVV solution. Moreover, home health claims without a confirmed visit will result in a payment denial for dates of service effective April 1, 2024, and forward. Furthermore, the following trainings have been conducted regarding utilization of Sandata Agency Management to capture home health visit data: a DELTA training geared towards home health providers currently using Sandata Agency Management; and a series of training sessions for new Sandata Agency Management users. The recordings are available for review on the Sandata on Demand (SoD) Web site for those who were unable to attend the trainings. To access the recordings and other helpful information on the SoD Web site, please log into your account on Sandata Technologies (sandata.zendesk.com), click Payer Programs, followed by Connecticut (CT DSS, DDS, MHW), and then Connecticut Instructional Videos. The DELTA training recording is available under the Connecticut Home Health Non-Waiver Delta Training Sessions tab. The training recordings for new Sandata Agency Management users are accessible under the Connecticut Home Health Non-Waiver Training Sessions 2023 tab. For providers using the Sandata Agency Management system, training is required to receive the EVV Welcome Kit. As for providers utilizing an Alternate EVV solution, Sandata self-paced online aggregator training must be completed once providers have received their EVV production credentials.
02/09/2024-02/16/2024Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the February 14, 2024 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". New claims will also appear on the February 14, 2024 RA with an ICN beginning with region code 27.
02/09/2024-02/16/2024Attention All ProvidersAttention All Providers. Provider Satisfaction Survey Reminder: Providers are reminded to participate in the Provider Satisfaction Survey. Providers may access this survey by going to Provider Bulletin PB24-03 and clicking on the link to the survey. The survey will be open through February 16, 2024.
02/09/2024-02/16/2024Attention Select ProvidersAttention Select Providers. PERFORMING PROVIDERS REQUIRED FOR BEHAVIORAL HEALTH CLINIC CLAIMS: DSS will require all claims to be submitted with an enrolled performing provider's National Provider Identifier (NPI). Currently, claims are not denied for the omission of the performing provider's NPI on Behavioral Health Clinic claims. Please refer to Provider Bulletin 2023-44 issued on June 5, 2023 for full policy. DSS has extended the time to allow providers to enroll performing providers for a full year providing sufficient time for your organization to comply. Claims will begin to deny for claims with dates of service 6/1/2024 forward. You are receiving this banner message as your organization still needs to enroll performing providers.
02/09/2024-02/16/2024Attention Outpatient Hospital ProvidersAttention Outpatient Hospital Providers. REPROCESSED THIS CYCLE: DSS and Gainwell Technologies have identified and reprocessed Outpatient and Outpatient Crossover claims where the claim header DOS is on or after January 1, 2024, claim contains a new procedure code and the claims processed on or before January 24, 2024, when the updated grouper was implemented. These claims have been reprocessed and will appear on the February 14, 2024, Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 61 or 27.
02/09/2024-02/16/2024Attention Select Hospital ProvidersAttention Select Hospital Providers. REPROCESSED THIS CYCLE: DSS and Gainwell Technologies have identified and reprocessed Outpatient and Outpatient Crossover APC claims that denied for edit 309 between 10/25/2023 and 1/30/2024. These claims have been reprocessed and will appear on the February 14, 2024 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27.
01/19/2024-01/26/2024Attention Select ProvidersAttention Select Providers. PERFORMING PROVIDERS REQUIRED FOR BEHAVIORAL HEALTH CLINIC CLAIMS: DSS will require all claims to be submitted with an enrolled performing provider's National Provider Identifier (NPI). Currently, claims are not denied for the omission of the performing provider's NPI on Behavioral Health Clinic claims. Please refer to Provider Bulletin 2023-44 issued on June 5, 2023 for full policy. DSS has extended the time to allow providers to enroll performing providers for a full year to provide sufficient time for your organization to comply. Claims will begin to deny for claims with dates of service 6/1/2024 forward. You are receiving this banner message as your organization still needs to enroll performing providers.
01/19/2024-01/26/2024Attention All ProvidersAttention All Providers. HOLIDAY CLOSURE: Please be advised, the Department of Social Services (DSS') office will be closed on Monday, February 12, 2024, in observance of the Lincoln's Birthday Holiday. The Department of Social Services (DSS) will re-open on Tuesday, February 13, 2024. Both the Department of Social Services (DSS) and Gainwell Technologies' offices will be closed on Monday, February 19, 2024, in observance of President's Day Holiday. The Department of Social Services (DSS) and Gainwell Technologies will re-open on Tuesday, February 20, 2024.
01/19/2024-01/26/2024Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified an issue where select professional and professional crossover claims submitted before December 20, 2023 incorrectly overpaid on procedure code 61650. These claims have been reprocessed and will appear on your January 23, 2024 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 52.
01/19/2024-01/26/2024Attention All ProvidersAttention All Providers. PROVIDER FILE MAINTENANCE: In order to maintain the accuracy and completeness of the Connecticut Medical Assistance Program (CMAP) network, we are requesting all providers update their provider file on a regular basis. The information that you provide is presented in the on-line provider directory at www.ct.gov/husky. Thousands of members statewide rely on the accuracy of this source of information to find a suitable health care provider. Inaccurate addresses, phone numbers, and names may affect a member's ability to contact you. To update your provider profile, the main account administrator can log into their secure Web account from the www.ctdssmap.com Web site and click on the "Demographic Maintenance" tab. Once on the Demographic Maintenance page, the provider can select from options listed as links below the Demographic Maintenance header panel. For instance, you can update your address* if you happen to move to a new location; all you have to do is click on the "Location Name Address" link, select the address to be updated, click on the "Maintain Address" button to type in the new address and then save your changes. You can also add or remove performing providers to your group practice as applicable by clicking on "Maintain Organization Members". For detailed instructions, please refer to Section 10.18 "Provider Demographic Maintenance" in Chapter 10 of the Provider Manual. The chapter is available from the Web site www.ctdssmap.com by clicking on "Publications" under Information, scrolling down to Provider Manuals and then clicking on "Web Portal/AVRS". Providers may contact the Provider Assistance Center at 1-800-842-8440 between the hours of 8:00 AM to 5:00 PM Monday through Friday if further assistance is needed in updating the information from their secure Web portal account. *There are special instructions for PCMH providers and licensed facilities such as hospitals, pharmacies, and clinic providers for updating their service location or alternate service location addresses. Please refer to the warning messages on the Web pages, as well as Chapter 10 for additional information.
01/19/2024-01/26/2024Attention Home Health ProvidersAttention Home Health Providers. Home health providers must prioritize onboarding and submission of Electronic Visit Verification (EVV) production data for all Home Health Care Services (HHCS) either via the State's EVV system (i.e., Sandata Agency Management) or an Alternate EVV solution. Moreover, home health claims without a confirmed visit will result in a payment denial for dates of service effective February 15, 2024, and forward. Furthermore, the following trainings have been conducted regarding utilization of Sandata Agency Management to capture home health visit data: a DELTA training geared towards home health providers currently using Sandata Agency Management; and a series of training sessions for new Sandata Agency Management users. The recordings are available for review on the Sandata on Demand (SoD) Web site for those who were unable to attend the trainings. To access the recordings and other helpful information on the SoD Web site, please log into your account on Sandata Technologies (sandata.zendesk.com), click Payer Programs, followed by Connecticut (CT DSS, DDS, MHW), and then Connecticut Instructional Videos. The DELTA training recording is available under the Connecticut Home Health Non-Waiver Delta Training Sessions tab. The training recordings for new Sandata Agency Management users are accessible under the Connecticut Home Health Non-Waiver Training Sessions 2023 tab. For providers using the Sandata Agency Management system, training is required to receive the EVV Welcome Kit. As for providers utilizing an Alternate EVV solution, Sandata self-paced online aggregator training must be completed once providers have received their EVV production credentials.
01/05/2024-01/12/2024Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the January 10, 2024 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". New claims will also appear on the January 10, 2024 RA with an ICN beginning with region code 27.
01/05/2024-01/12/2024Attention Home Health ProvidersAttention Home Health Providers. Home health providers must prioritize onboarding and submission of Electronic Visit Verification (EVV) production data for all Home Health Care Services (HHCS) either via the State's EVV system (i.e., Sandata Agency Management) or an Alternate EVV solution. Moreover, home health claims without a confirmed visit will result in a payment denial for dates of service effective February 1, 2024, and forward. Furthermore, the following trainings have been conducted regarding utilization of Sandata Agency Management to capture home health visit data: a DELTA training geared towards home health providers currently using Sandata Agency Management; and a series of training sessions for new Sandata Agency Management users. The recordings are available for review on the Sandata on Demand (SoD) Web site for those who were unable to attend the trainings. To access the recordings and other helpful information on the SoD Web site, please log into your account on Sandata Technologies (sandata.zendesk.com), click Payer Programs, followed by Connecticut (CT DSS, DDS, MHW), and then Connecticut Instructional Videos. The DELTA training recording is available under the Connecticut Home Health Non-Waiver Delta Training Sessions tab. The training recordings for new Sandata Agency Management users are accessible under the Connecticut Home Health Non-Waiver Training Sessions 2023 tab. For providers using the Sandata Agency Management system, training is required to receive the EVV Welcome Kit. As for providers utilizing an Alternate EVV solution, Sandata self-paced online aggregator training must be completed once providers have received their EVV production credentials.
  
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