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- 2022 Important Messages Archived
Message Effective DateTitle
09/11/2022-10/05/2022

Hospital Monthly Important Message (Posted 9/12/22)
08/12/2022-10/31/2022

Attention Providers: Reimbursement for COVID-19 Monoclonal Antibody Therapy (Posted 8/12/22)
08/08/2022-09/08/2022

CMAP Addendum B July 2022 (Posted 8/8/22)
08/08/2022-09/09/2022

Hospital Monthly Important Message (Posted 8/8/22)
08/01/2022-09/01/2022

Attention All Providers: Medical Authorization Portal (Posted 8/1/22)
07/19/2022-08/31/2022

Attention Home Health and Access Agencies: Correction to the Home Health Fee Schedule (Posted 7/19/22)
07/18/2022-11/15/2022

COVID-19 Information and FAQs (Updated 7/18/22)
07/11/2022-08/15/2022

Hospital Monthly Important Message (Posted 7/11/2022)
07/11/2022-07/11/2022

Attention Trading Partners: Service Interruption (Posted 7/11/22)
07/07/2022-08/07/2022

Attention Dental Providers and Dental Clinics: Adult Dental Fee Schedule Updates (Posted 7/7/22)
07/07/2022-08/07/2022

Attention All Providers: Covered CT Member Eligibility (Posted 7/7/22)
06/24/2022-08/31/2022

Attention All Providers: Statements From the Commissioners of Public Health and Social Services on Today's SCOTUS Ruling Overturning Roe v. Wade (Posted 6/24/22)
06/24/2022-07/31/2022

Attention ICF/IID Providers: ICF/IID Reimbursement Public Notice (Posted 6/24/22)
06/24/2022-07/31/2022

Attention Hospital Providers: Hospital Reimbursement Public Notice (Posted 6/24/22)
06/22/2022-07/31/2022

Attention Nursing Facility Providers: Nursing Facility Reimbursement Public Notice (Posted 6/22/22)
06/13/2022-07/10/2022

Hospital Monthly Important Message (Posted 6/13/22)
06/06/2022-07/31/2022

Attention Providers: Registration for the New Medical Authorization Portal (Posted 6/6/22)
06/01/2022-07/15/2022

Final Reminder - Attention All Providers and Trading Partners: Upcoming Financial Cycle Date Change Notification (Posted 6/1/22)
05/27/2022-07/31/2022

Attention Home and Community Based Waiver Providers: URGENT - Change in Value Based Payment Requirement for Participation in Racial Equity Training (Posted 5/27/22)
05/27/2022-05/31/2022

Reminder - Attention All Providers and Trading Partners: Upcoming Financial Cycle Date Change Notification (Updated 5/27/22)
05/27/2022-07/31/2022

Attention Home Health Agencies: URGENT - Change in Value Based Payment Requirement for Participation in Racial Equity Training (Posted 5/27/22)
05/20/2022-05/26/2022

Attention All Providers and Trading Partners: Upcoming Financial Cycle Date Change Notification (Posted 5/20/22)
05/18/2022-07/15/2022

Attention Home and Community Based Waiver Providers: Urgent - Immediate Action Required to Receive 1% Rate Increase Through Value-Based Payments(VBP) (Posted 5/18/22)
05/18/2022-07/15/2022

Attention Home Home Health Agencies: Urgent - Immediate Action Required to Receive 1% Rate Increase Through Value-Based Payments (VBP) (Posted 5/18/22)
05/12/2022-06/30/2022

Attention Acupuncture Providers: Updated Claim Submission Instructions for Dual Eligible Beneficiaries (Posted 5/12/22)
05/09/2022-06/12/2022

Hospital Monthly Important Message (Posted 5/9/22)
05/06/2022-05/31/2022

CMAP Addendum B April 2022 (Posted 5/6/22)
05/05/2022-08/05/2022

Attention Durable Medical Equipment Providers (DME): Incontinence Supplies Claims Processing Issue (Posted 5/5/22)
05/02/2022-07/17/2022

COVID-19 Information and FAQs (Updated 5/2/22)
04/27/2022-05/01/2022

COVID-19 Information and FAQs (Updated 4/27/22)
04/27/2022-06/15/2022

Attention Providers - Upcoming Provider Training New Medical Authorization Portal (Posted 4/27/22)
04/21/2022-06/30/2022

Attention Behavioral Health Federally Qualified Health Center (FQHC) Providers: Update to Prior Authorization (PA) Requirements (Posted 4/21/22)
04/11/2022-05/08/2022

Hospital Monthly Important Message (Posted 4/11/22)
04/01/2022-05/31/2022

Attention Home and Community-Based Service Providers: ARPA One-Time Stabilization Payment (Posted 4/1/22)
04/01/2022-06/30/2022

Attention All Providers: Extension of Postpartum Coverage for Eligible HUSKY Health Members (Posted 4/1/22)
04/01/2022-06/30/2022

Attention All Providers: New Eligibility Group: HUSKY B - Prenatal Care (Posted 4/1/22)
03/30/2022-04/26/2022

COVID-19 Information and FAQs (Updated 3/30/22)
03/29/2022-05/31/2022

Attention Nursing Facility Providers: Nursing Facility Reimbursement Public Notice (Posted 3/29/22)
03/25/2022-05/31/2022

Attention All Home Health Agencies, Acquired Brain Injury, Connecticut Home Care, Personal Care Assistant, Autism and Mental Health Waiver Providers: Rate Increase Claim Reprocessing (Posted 3/25/22)
03/24/2022-06/30/2022

Attention Home and Community Based Waiver Providers, Homemaker and Companion Agencies: Important Update (Posted 3/24/22)
03/16/2022-03/29/2022

COVID-19 Information and FAQs (Updated 3/16/22)
03/10/2022-04/15/2022

Attention Home Health Agencies, Acquired Brain Injury, Connecticut Home Care, Personal Care Assistant, Autism and Mental Health Waiver Providers - Rates Update (Posted 3/10/22)
03/07/2022-04/10/2022

Hospital Monthly Important Message (Posted 3/7/22)
03/04/2022-04/04/2022

Attention Federally Qualified Health Centers (FQHCs), Medical Clinics, Advanced Practice Registered Nurses, Physicians and Physician Assistants: Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey (Posted 3/4/22)
03/01/2022-03/15/2022

COVID-19 Information and FAQs (Updated 3/1/22)
02/28/2022-06/01/2022

Attention All Pharmacy Providers - Factor Drugs Dispensing Fee Update (Posted 2/28/22)
02/22/2022-03/11/2022

Attention All Providers: Medicare Part A and B Crossover Claims (Posted 2/22/22)
02/18/2022-02/28/2022

COVID-19 Information and FAQs (Updated 2/18/22)
02/17/2022-02/28/2022

Attention Outpatient Hospitals: CMAP Addendum B Claims Reprocessing (Posted 2/17/22)
02/14/2022-02/14/2022

Attention Pharmacy Providers: Service Interruption Notification (Posted 2/15/22)
02/10/2022-02/22/2022

Attention All Home Health Agencies: Rate Increase Claim Reprocessing (Posted 2/10/22)
02/09/2022-03/10/2022

CMAP Addendum B January 2022 (Posted 2/9/22)
02/08/2022-03/08/2022

Attention All Home Health Agencies/Access Agencies: Clarification to Provider Bulletin 2022-03 and Provider Bulletin 2022-04 regarding Prior Authorization (PA) for Home Health Services (Posted 2/8/22)
02/07/2022-03/04/2022

Hospital Monthly Important Message (Posted 2/7/22)
02/01/2022-02/28/2022

Attention Providers: Revised Monthly Provider Manual Chapters (Updated 2/1/22)
01/28/2022-02/28/2022

Attention Acupuncture Providers: Claim Submission Instructions for Dual Eligible Beneficiaries (Posted 1/28/22)
01/26/2022-02/28/2022

Attention Ambulance Providers: NEMT Procedure Code - A0429 Fee Correction (Posted 1/26/22)
01/21/2022-02/28/2022

Attention All Providers: 2021 1099s Available on Web Site (Posted 1/21/22)
01/20/2022-02/22/2022

Attention Home Health Providers: Reimbursement Rate Increases for Home Health Services (Updated 1/20/22)
01/18/2022-03/15/2022

Attention Home and Community Based Waiver Providers: URGENT: FINAL NOTICE - IMMEDIATE ACTION REQUIRED to receive 1% rate increase through value-based payments (VBP) (Updated 1/18/22)
01/18/2022-03/15/2022

Attention Home Health Agencies: URGENT: FINAL NOTICE - IMMEDIATE ACTION REQUIRED to receive 1% rate increase through value-based payments (VBP) (Updated 1/18/22)
01/14/2022-01/14/2022

Attention Pharmacy Providers: Service Interruption Notification (Posted 1/14/22)
01/12/2022-01/31/2022

Attention Hospital Providers: DRG Calculator (Updated 1/11/22)
01/10/2022-02/06/2022

Hospital Monthly Important Message (Posted 1/10/22)
01/10/2022-01/31/2022

Attention Providers: Revised Monthly Provider Manual Chapters (Updated 1/10/22)
01/03/2022-01/11/2022

Attention Hospital Providers: DRG Calculator Updated (Posted 1/3/22)
  
+ 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
  
- 2022 RA Banner Announcements Archived
Banner Effective DateProvidersBanner Page Announcement
11/18/2022-11/25/2022Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims previously submitted for the COVID Administration procedure codes. The impacted claims will appear on the November 22, 2022 Remittance Advice (RA) beginning with an Internal Control Number (ICN) 52.
11/18/2022-11/25/2022Attention Pharmacy ProvidersAttention Pharmacy Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed pharmacy claims submitted between 7/22/2022 and 11/3/2022 for Cabenuva- cabotegravir and rilpivirine kit, NDC 49702-0240-15, which did not pay the pharmacy dispensing fee. The claims have been reprocessed to add the dispensing fee and will appear on the November 22, 2022 Remittance Advice (RA) beginning with an Internal Control Number (ICN) 52.
11/18/2022-11/25/2022Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your November 22, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
11/04/2022-11/11/2022Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims previously submitted for the COVID Administration procedure codes. The impacted claims will appear on the November 8, 2022 Remittance Advice (RA) beginning with an Internal Control Number (ICN) 52.
11/04/2022-11/11/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the November 8, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefits (EOB) code 8239 "ACA CLIENT TEMP ID REPLACED WITH CMAP ID. NEW CLAIM WILL BE SYSTEMATICALLY GENERATED". The new claims will also appear on the November 8, 2022 RA with an ICN beginning with region code 27.
11/04/2022-11/11/2022Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified claims that were not included in the June 2022 Rate Mass Adjustment cycle. These claims have been identified and reprocessed and will appear on the November 8, 2022 Remittance Advice (RA).
10/07/2022-10/14/2022Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims that denied in error. The reprocessed claims will appear on the October 12, 2022 Remittance Advice (RA) with an ICN beginning with region code 52.
10/07/2022-10/14/2022Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which incorrectly denied on or after August 15, 2022 with procedure code Q0222. The reprocessed claims will appear on the October 12, 2022 Remittance Advice (RA) with an ICN beginning with region code 50.
10/07/2022-10/14/2022Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims for dates of services beginning January 17, 2022 and forward. The reprocessed claims will appear on the October 12, 2022 Remittance Advice (RA) with an ICN beginning with region 52.
10/07/2022-10/14/2022Attention 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 October 12, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefits (EOB) code 8239 "ACA CLIENT TEMP ID REPLACED WITH CMAP ID. NEW CLAIM WILL BE SYSTEMATICALLY GENERATED". The new claims will also appear on the October 12, 2022 RA with an ICN beginning with region code 27.
09/23/2022-09/30/2022Attention All ProvidersAttention All Providers. HOLIDAY CLOSURE: Please be advised, the Department of Social Services (DSS) and Gainwell Technologies will be closed on Monday, October 10, 2022 in observance of the Columbus Day holiday. Both the DSS and Gainwell Technologies offices will re-open on Tuesday, October 11, 2022.
09/23/2022-09/30/2022Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your September 27, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
09/23/2022-09/30/2022Attention Primary Care ProvidersAttention Primary Care Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims for providers who were retroactively approved for the HUSKY Health Primary Care Increased Payments policy. The impacted claims have been reprocessed and will appear on your September 27, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52.
09/23/2022-09/30/2022Attention PCMH Primary Care ProvidersAttention PCMH Primary Care Providers. REPROCESSED THIS CYCLE: Primary Care Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or end dated from the PCMH program. Claims which processed prior to the completion of the provider's PCMH enrollment were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For those providers retroactively end dated, claims were paid with the PCMH differential payment rate that have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your September 27, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
09/09/2022-09/16/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially paid and posted one of the following informational Ordering, Prescribing, Referring (OPR) Explanation of Benefit (EOB) codes, but for which the provider in question has since successfully enrolled in the Connecticut Medical Assistance Program (CMAP): * EOB Code 0237-PRESCRIBING PROVIDER IS A STUDENT OR RESIDENT AND MUST BE ENROLLED TO PRESCRIBE * EOB Code 0027-CLAIM BYPASSED EDIT 0207 DUE TO PPE AUTO-PA * EOB Code 0207-PRESCRIBER NOT ENROLLED * EOB Code 0028-PRESCRIBING PROVIDER IN PROCESS OF ENROLLING * EOB Code 1040-ORDERING/REFERRING/ATTENDING PROVIDER IS NOT ENROLLED ON DATE OF SERVICE These claims will appear on the September 13, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
08/19/2022-08/26/2022Attention Select Home Health AgenciesAttention Select Home Health Agencies. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the August 19, 2022 claims cycle. The recoupments are related to a Home Health Agency settlement with CMS and will appear on your August 23, 2022 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
08/19/2022-08/26/2022Attention Select ProvidersAttention Select Providers. PAXLOVID CLAIMS: Gainwell Technologies has identified Paxlovid claims for Husky B beneficiaries which inadvertently assigned a co-pay when they were initially processed. The impacted claims have been identified and reprocessed and will appear on your August 23, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52. Pharmacies are asked to refund the co-pays to the patients.
08/19/2022-08/26/2022Attention Select Skilled Nursing FacilitiesAttention Select Skilled Nursing Facilities. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the August 19, 2022 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your August 23, 2022 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
08/19/2022-08/26/2022Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your August 23, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
08/05/2022-08/12/2022Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims for select providers where procedure code 99401 with modifier SC was billed for dates of service 4/21/2021 through 6/30/2022. The reprocessed claims will appear on the August 9, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
08/05/2022-08/12/2022Attention 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 clicking on "Publications" under Information, scrolling down to Provider Manuals and then clicking on "Web Portal/AVRS". You 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 your secure Web 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.
08/05/2022-08/12/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client?s true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the August 9, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefits (EOB) code 8239 "ACA CLIENT TEMP ID REPLACED WITH CMAP ID. NEW CLAIM WILL BE SYSTEMATICALLY GENERATED". The new claims will also appear on the August 9, 2022 RA with an ICN beginning with region code 27.
07/22/2022-07/29/2022Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your July 26, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
07/22/2022-07/29/2022Attention HCBS Providers and Home Health AgenciesAttention HCBS Providers and Home Health Agencies. PROCESSED THIS CYCLE: Those providers who qualified to receive the 1% provider value based payment (VBP) under the American Rescue Plan Act program (ARPA) will see these payments in the Remittance Advice dated July 26, 2022 with a reason code indicating ARPA 1% VBP.
07/08/2022-07/15/2022Attention Pharmacy ProvidersAttention Pharmacy Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed pharmacy claims for HUSKY B members which originally assigned a copay. Due to legislative changes, drugs in select drug classes such as antiemetics, prenatal vitamins, and iron supplements will no longer require a copay. These claims have been reprocessed to refund the copay and will appear on the July 12, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52. Pharmacies are asked to refund the HUSKY B members for the copays incurred.
07/08/2022-07/15/2022Attention ProvidersAttention Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed professional claims with dates of service of 5/21/2021 thru 5/26/2022, which incorrectly denied due to lack of PA. The procedure codes in question are exempt from PA requirements and the reprocessed claims will appear on the July 12, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
07/08/2022-07/15/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the July 12, 2022 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 12, 2022 RA with an ICN beginning with region code 27.
07/08/2022-07/15/2022Attention Professional ProvidersAttention Professional Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed professional claims with dates of service of January 1, 2021 and forward, which erroneously reimbursed non-payable procedure codes S0515, S9145, S8100, S8101, S9441 and S9443. The payments for these codes have been recouped and the reprocessed claims will appear on the July 12, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and EOB 4831 "Service not payable on date on service."
07/08/2022-07/15/2022Attention 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". You 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 your secure Web 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.
06/22/2022-06/29/2022Attention Department of Developmental Services (DDS) Billing ProvidersAttention Department of Developmental Services (DDS) Billing Providers. SPECIAL RATE MASS ADJUSTMENT CYCLE: The Department of Social Services (DSS) has requested that Gainwell Technologies run a special rate mass adjustment cycle due to recent Fiscal Year (FY) 2019, FY 2020, FY 2021 and FY 2022 rate changes, to adjust paid DDS claims with dates of service impacted September 1, 2018 to April 30, 2022. These claims will process in the June 24, 2022 special cycle and will appear on your June 28, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/17/2022-06/21/2022Attention Primary Care ProvidersAttention Primary Care Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims for providers who were retroactively approved for the HUSKY Health Primary Care Increased Payments policy. The impacted claims have been reprocessed and will appear on your June 21, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52.
06/17/2022-06/21/2022Attention PCMH Primary Care ProvidersAttention PCMH Primary Care Providers. REPROCESSED THIS CYCLE: Primary Care Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or end dated from the PCMH program. Claims which processed prior to the completion of the provider's PCMH enrollment were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For those providers retroactively end dated, claims were paid with the PCMH differential payment rate that have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your June 21, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/17/2022-06/21/2022Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your June 21, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/03/2022-06/10/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially paid and posted one of the following informational Ordering, Prescribing, Referring (OPR) Explanation of Benefit (EOB) codes, but for which the provider in question has since successfully enrolled in the Connecticut Medical Assistance Program (CMAP): - EOB Code 0237-PRESCRIBING PROVIDER IS A STUDENT OR RESIDENT AND MUST BE ENROLLED TO PRESCRIBE - EOB Code 0027-CLAIM BYPASSED EDIT 0207 DUE TO PPE AUTO-PA - EOB Code 0207-PRESCRIBER NOT ENROLLED - EOB Code 0028-PRESCRIBING PROVIDER IN PROCESS OF ENROLLING - EOB Code 1040-ORDERING/REFERRING/ATTENDING PROVIDER IS NOT ENROLLED ON DATE OF SERVICE These claims will appear on the June 7, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
06/03/2022-06/10/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: It has come to the Department of Social Services' (DSS') attention that there are claims that electronically crossed-over directly from Medicare to the Connecticut Medical Assistance Program (CMAP) between May 30, 2022 through May 31, 2022 that are denying for Explanation of Benefits (EOB) code 2513 - Other Payer Adjudication Date is Invalid. Medicare has communicated that due to the recent holiday, there was a delay in their batch claims cycle(s), resulting in the Medicare payment date being later than the date the claims crossed over to CMAP. Claims that set this edit due to the delay in Medicare's payment date(s) were systematically identified and reprocessed and will appear on the June 7, 2022 Remittance Advice (RA).
06/03/2022-06/10/2022Attention 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 June 7, 2022 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 7, 2022 RA with an ICN beginning with region code 27.
05/20/2022-05/27/2022Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your May 24, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
05/20/2022-05/27/2022Attention All ProvidersAttention All Providers. HOLIDAY CLOSURE: Please be advised, the Department of Social Services (DSS) and Gainwell Technologies will be closed on Monday, May 30, 2022 in observance of the Memorial Day holiday. Both the DSS and Gainwell Technologies offices will re-open on Tuesday, May 31, 2022.
05/20/2022-05/27/2022Attention PCA Waiver Access Agency and CFC Fiscal Intermediary for PCA ServicesAttention PCA Waiver Access Agency and CFC Fiscal Intermediary for PCA Services. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims this cycle which failed to set a duplicate audit against previously paid claims, resulting in select claims paying twice for the same client, provider, dates of service and procedure code(s). These claims will appear on the May 25, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a Region code 52.
05/06/2022-05/13/2022Attention Select Home Health AgenciesAttention Select Home Health Agencies. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the May 6, 2022 claims cycle. The recoupments are related to a Home Health Agency settlement with CMS and will appear on your May 10, 2022 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
05/06/2022-05/13/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the May 10, 2022 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 10, 2022 RA with an ICN beginning with region code 27.
05/06/2022-05/13/2022Attention Select Skilled Nursing FacilitiesAttention Select Skilled Nursing Facilities. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the May 6, 2022 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your May 10, 2022 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
04/22/2022-04/29/2022Attention Behavioral Health FQHCsAttention Behavioral Health FQHCs. REPROCESSED THIS CYCLE: Gainwell Technologies has identified issue where claims were denying for EOB 3003 "PRIOR AUTHORIZATION IS REQUIRED FOR PAYMENT" in error. A portion of the impacted claims have been identified and reprocessed and will appear on the April 26, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27. The remaining claims will be re-processed in a future cycle.
04/08/2022-04/15/2022Attention Select Skilled Nursing FacilitiesAttention Select Skilled Nursing Facilities. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the April 8, 2022 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your April 12, 2022 Remittance Advice (RA) under Accounts Receivable with reason code 8407 ?CMS Settlement?.
03/25/2022-04/01/2022Attention All Home Health Agencies, Acquired Brain Injury, Connecticut Home Care, Personal Care Assistant, Autism and Mental Health Waiver ProvidersAttention All Home Health Agencies, Acquired Brain Injury, Connecticut Home Care, Personal Care Assistant, Autism and Mental Health Waiver Providers. RATE INCREASE CLAIM REPROCESSING: The Department of Social Services (DSS) has advised Gainwell Technologies to run a special cycle to reprocess home health and waiver claims that had a rate increase retroactive to July 1, 2021 and have not yet been systematically re-processed. The re-processed claims will appear on your March 29, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code of 53. Value Based Payment (VBP) Reminder: Requirements for the next 1% VBP must be met by June 1, 2022 with the payment following on or before July 31, 2022.
03/18/2022-03/24/2022Attention HCBS Providers and Home Health AgenciesAttention HCBS Providers and Home Health Agencies. PROCESSED THIS CYCLE: Those providers who qualified to receive the 1% provider value based payment (VBP) under the American Rescue Plan Act program (ARPA) will see these payments in the Remittance Advice dated March 22, 2022 with a reason code indicating ARPA 1% VBP.
03/18/2022-03/24/2022Attention PCMH Primary Care ProvidersAttention PCMH Primary Care Providers. REPROCESSED THIS CYCLE: Primary Care Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or end dated from the PCMH program. Claims which processed prior to the completion of the provider?s PCMH enrollment were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For those providers retroactively end dated, claims were paid with the PCMH differential payment rate that have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your March 22, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/18/2022-03/24/2022Attention 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 22, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/18/2022-03/24/2022Attention Primary Care ProvidersAttention Primary Care Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims for providers who were retroactively approved for the HUSKY Health Primary Care Increased Payments policy. The impacted claims have been reprocessed and will appear on your March 22, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52.
03/10/2022-03/17/2022Attention Department of Developmental Services (DDS) Billing ProvidersAttention Department of Developmental Services (DDS) Billing Providers. SPECIAL RATE MASS ADJUSTMENT CYCLE: The Department of Social Services (DSS) has requested that Gainwell Technologies run a special rate mass adjustment cycle due to rate changes, to adjust paid DDS claims with dates of service July 1, 2021 and forward. These claims will process in the March 10, 2022 special cycle and will appear on your March 15, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/04/2022-03/09/2022Attention Pharmacy ProvidersAttention Pharmacy Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims for over-the-counter COVID-19 rapid tests which initially paid and assigned a copay for HUSKY B clients. The claims have been reprocessed to pay in full, without the copay responsibility. Additionally, claims submitted with the National Provider Identifier (NPI) of a pharmacy or pharmacist as the prescribing provider have been reprocessed according to the guidelines published in PB 2022-15. The reprocessed claims will appear on your March 8, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) that begins with region code 52.
03/04/2022-03/09/2022Attention Independent Laboratories and Outpatient HospitalsAttention Independent Laboratories and Outpatient Hospitals. REPROCESSED THIS CYCLE: PB 2022-10 The Addition of COVID-19 Proprietary Laboratory Analyses Codes to the Independent Laboratory Fee Schedule was distributed to providers in February 2022 to address the addition of procedure codes to the lab fee schedule. Any claims previously submitted with the impacted procedure codes will be systematically identified and reprocessed in the upcoming financial cycle. The reprocessed claims will appear on your March 8, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) that begins with region code 52 and 27.
03/04/2022-03/09/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the March 8, 2022 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 8, 2022 RA with an ICN beginning with region code 27.
03/04/2022-03/09/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially paid and posted one of the following informational Ordering, Prescribing, Referring (OPR) Explanation of Benefit (EOB) codes, but for which the provider in question has since successfully enrolled in the Connecticut Medical Assistance Program (CMAP): -EOB Code 0237-"PRESCRIBING PROVIDER IS A STUDENT OR RESIDENT AND MUST BE ENROLLED TO PRESCRIBE" - EOB Code 0027-"CLAIM BYPASSED EDIT 0207 DUE TO PPE AUTO-PA " - EOB Code 0207-"PRESCRIBER NOT ENROLLED " - EOB Code 0028-"PRESCRIBING PROVIDER IN PROCESS OF ENROLLING " - EOB Code 1040- "ORDERING/REFERRING/ATTENDING PROVIDER IS NOT ENROLLED ON DATE OF SERVICE " These claims will appear on the March 8, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
02/18/2022-02/25/2022Attention Access Agencies, Connecticut Home Care Service Providers and Other Provider Agencies Interested in Delivering Support and Planning Coach ServicesAttention Access Agencies, Connecticut Home Care Service Providers and Other Provider Agencies Interested in Delivering Support and Planning Coach Services. NEW COMMUNITY BASED SERVICES ENROLLMENT OPPORTUNITY: The Department of Social Services has recently announced via Provider Bulletin PB 2022-01, published in January 2022, that it will be enrolling a new provider specialty, Support and Planning Coach, under the Community First Choice (CFC) Program. Providers enrolling as a Support and Planning Coach must first be credentialed by Allied Community Services to provide one or both of the allowed services: 2043Z -Support and Planning Coach, Agency and/or H2014 - Skills Training and Development for S&P Coach Electronic Visit Verification Assistance services. Providers will bill these services directly to Gainwell Technologies to obtain reimbursement for the services provided. FOR MORE INFORMATION, interested providers should login to the www.ctdssmap.com Web site and click on Publications > Bulletin Search and select year 22 and number 01 using the dropdown arrow selections in each field, then click Search. Click on the PB22-01 line to access the bulletin. SCHEDULED ENROLLMENT TRAINING: Providers interested in attending one of two virtual workshops scheduled via Microsoft Teams can do so by accessing the www.ctdssmap.com Web site. From the Home page, click the "Provider Training" link. Scroll to Workshop Invitations and click on the "Community First Choice (CFC) Support and Planning Coach Providers Enrollment Workshop Invitation" to sign-up for the workshop of your choice.
02/04/2022-02/10/2022Attention Access Agencies, Connecticut Home Care Service Providers and other Provider Agencies Interested in Delivering Support and Planning Coach ServicesAttention Access Agencies, Connecticut Home Care Service Providers and other Provider Agencies Interested in Delivering Support and Planning Coach Services. NEW COMMUNITY BASED SERVICES ENROLLMENT OPPORTUNITY: The Department of Social Services has recently announced via Provider Bulletin PB 2022-01, published in January 2022, that it will be enrolling a new provider specialty, Support and Planning Coach (S & P), under the Community First Choice (CFC) Program. Providers enrolling as a Support and Planning Coach must first be credentialed by Allied Community Resources to provide one or both of the allowed services: 2043Z - Support and Planning Coach, Agency and/or H2014 - Skills Training and Development for S & P Coach Electronic Visit Verification Assistance services. Providers will bill these services directly to Gainwell Technologies to obtain reimbursement for the services provided. FOR MORE INFORMATION, interested providers should go to the www.ctdssmap.com Web site and click on Information > Publications > Bulletin Search and select Year 22 and Number 01 using the dropdown arrow selections in each field, then click Search. Click on the PB22-01 line to access the bulletin.
02/04/2022-02/10/2022Attention Select Home Health AgenciesAttention Select Home Health Agencies. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the February 4, 2022 claims cycle. The recoupments are related to a Home Health Agency settlement with CMS and will appear on your February 8, 2022 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
02/04/2022-02/10/2022Attention Select Home and Community Based Service Providers and Home Health AgenciesAttention Select Home and Community Based Service Providers and Home Health Agencies. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims that processed against an incorrect visit record. The reprocessed claims will appear on your February 8, 2022 (RA) with an Internal Control Number (ICN) beginning with a region code of 52.
02/04/2022-02/10/2022Attention Home Health AgenciesAttention Home Health Agencies. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and is reprocessing claims with procedure codes that had a rate increase effective August 1, 2021. The reprocessed claims will appear on the next two (2) cycle payments, February 8, 2022 and February 23, 2022, and will appear on your RA with an Internal Control Number (ICN) beginning with a region code of 52. Note: If claims were submitted using a Revenue Center Code (RCC) and a procedure code, these claims were already mass adjusted and appeared on your January 25, 2022 Remittance Advice (RA).
02/04/2022-02/10/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the February 8, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefits (EOB) code 8239 "ACA CLIENT TEMP ID REPLACED WITH CMAP ID. NEW CLAIM WILL BE SYSTEMATICALLY GENERATED". The new claims will also appear on the February 8, 2022 RA with an ICN beginning with region code 27.
02/04/2022-02/10/2022Attention Select Skilled Nursing FacilitiesAttention Select Skilled Nursing Facilities. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the February 4, 2022 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your February 8, 2022 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
02/04/2022-02/10/2022Attention PharmaciesAttention Pharmacies. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims for COVID-19 vaccines submitted via Point of Sale with a submission clarification code of '06', which initially processed and paid more than the allowed amount of $40.00 as described in Provider Bulletin 2021-91. The claims were reprocessed to reimburse at the correct amount and will appear on your February 8, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
01/21/2022-01/28/2022Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your January 25, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
01/07/2022-01/14/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the January 11, 2022 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 11, 2022 RA with an ICN beginning with region code 27.
01/07/2022-01/14/2022Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: It has come to the Department of Social Services' (DSS') attention that there are claims that electronically crossed-over directly from Medicare to the Connecticut Medical Assistance Program (CMAP) between December 23, 2021 through January 3, 2022 that are denying for Explanation of Benefits (EOB) code 2513 - "Other Payer Adjudication Date is Invalid." Medicare has communicated that due to the recent holidays, there was a delay in their batch claims cycle(s), resulting in the Medicare payment date being later than the date the claims crossed over to CMAP. Claims that set this edit due to the delay in Medicare's payment date(s) were systematically identified and reprocessed and will appear on the hospital's January 11, 2022 Remittance Advice (RA).
01/07/2022-01/14/2022Attention Outpatient Hospital ProvidersAttention Outpatient Hospital Providers. REPROCESSED THIS CYCLE: Gainwell Technologies had identified an issue with Ambulatory Payment Classification (APC) weights that were incorrectly uploaded as whole numbers with the CMAP Addendum B updates on October 28, 2021. The APC weights were restored to their correct values on November 9, 2021 and any claims processed as of November 10, 2021 and forward used the correct APC weight values. Most impacted claims were systematically mass adjusted and appeared on the hospital's December 21, 2021 Remittance Advice (RA). However, a subset of impact claims remained to be systematically mass adjusted. Those will appear on the hospital's January 11, 2022 Remittance Advice (RA) with an Internal Control Number (ICN) region code of 55. Claims that originally processed with the correct weights that are currently in suspense will be systematically de-selected from the mass adjustment and will no longer appear for providers if there were no valid APC data changes related to the October Addendum B updates.
  
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