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- 2018 Important Messages Archived
Message Effective DateTitle
09/13/2018-09/15/2018

Attention Providers: Automated Voice Response System Downtime Notification (Posted 9/13/18)
08/21/2018-09/20/2018

Electronic Visit Verification Important Message (Updated 8/20/18)
08/16/2018-09/10/2018

Hospital Monthly Important Message (Posted 8/15/18)
08/06/2018-09/01/2018

Attention Dental Providers: Restoration Pricing Update (Updated 8/6/18)
08/01/2018-09/01/2018

Electronic Visit Verification Service Providers (EVV) - Consecutive Services Enhancement (Posted 8/1/18)
07/26/2018-09/01/2018

Attention Dental Providers: Restoration Pricing Policy Update (Posted 7/26/18)
07/18/2018-08/30/2018

Revised Provider Manual Chapters (Updated 7/18/18)
07/11/2018-08/15/2018

Hospital Monthly Important Message (Posted 7/11/18)
06/28/2018-07/02/2018

Attention Web Portal Users - Account Disabled Message Issue Resolved (Posted 6/28/18)
06/25/2018-07/25/2018

Attention Providers & Trading Partners: Provider Bulletin PB18-34 Reminder (Posted 6/25/18)
06/19/2018-09/16/2018

Attention Primary Care Providers - Upcoming Continuing Medical Education (CME) Conference (Posted 6/19/18)
06/18/2018-06/18/2018

Attention Select Providers: Claims Processing Issue (Posted 6/19/18)
06/13/2018-07/10/2018

Hospital Monthly Important Message (Posted 6/13/18)
06/13/2018-07/13/2018

Reporting a Change in Client Condition Functionality Update (Posted 6/13/18)
06/06/2018-07/31/2018

Attention Electronic Visit Verification (EVV) Service Providers - Mobile Visit Verification (MVV) App Update (Posted 6/8/18)
06/05/2018-06/30/2018

Provider Bulletin PB18-32 Supervision of Licensed Master Social Workers Being Rescinded
05/11/2018-06/27/2018

Electronic Visit Verification Implementation Important Message (Posted 5/11/18)
05/10/2018-06/12/2018

Hospital Monthly Important Message (Posted 5/10/18)
05/02/2018-07/18/2018

Attention All Providers: Information Required When Contacting the Transportation Broker to Schedule Non-Emergency Medical Transportation
04/19/2018-05/08/2018

Electronic Visit Verification Implementation Important Message (Posted 4/18/18)
04/10/2018-05/08/2018

Hospital Monthly Important Message (Updated 4/11/18)
04/09/2018-06/30/2018

Additional Guidance on the Use of the Home Health SOC/ROC and Recertification Service Codes for CHC, ABI, PCA and Autism Waiver Clients (Posted 4/9/18)
04/06/2018-04/27/2018

Electronic Visit Verification (EVV) - Future Training Survey (Posted 4/6/18)
04/05/2018-04/08/2018

ATTENTION PROVIDERS: Scheduled Power Outage Notification (Posted 4/5/18)
04/02/2018-05/31/2018

Attention Providers: Cologuard Reminder (Posted 4/2/18)
03/29/2018-04/15/2018

ATTENTION LONG TERM CARE PROVIDERS: Banner Page Message Issue (Posted 3/29/18)
03/27/2018-04/11/2018

ATTENTION NURSING HOME PROVIDERS: Financial Transactions Notification (Posted 3/27/18)
03/23/2018-05/31/2018

ATTENTION MEDS PROVIDERS: Revisions to Previously Announced Reimbursement Changes to Durable Medical Equipment (DME) and Other MEDS Items (Posted 3/23/18)
03/21/2018-03/26/2018

ATTENTION PROVIDERS: Claims Processing Delay (Posted 3/21/18)
03/20/2018-05/31/2018

ATTENTION MEDS PROVIDERS: Opportunity to Provide Voluntary Cost Information to DSS to Assist with Reimbursement Analysis (Posted 3/20/18)
03/14/2018-04/09/2018

Hospital Monthly Important Message (Updated 3/14/18)
03/07/2018-07/18/2018

Resident Step-by-Step Enrollment Instruction Guide
03/06/2018-04/01/2018

Prior Authorization Requirements for Advanced Imaging Services Reminder in an Outpatient Hospital Setting
03/05/2018-05/02/2018

Revised Provider Manual Chapters (Updated 3/5/18)
03/01/2018-03/21/2018

CMAP Addendum B (Updated 3/1/18)
02/14/2018-03/12/2018

Hospital Monthly Important Message (Updated 2/14/18)
02/06/2018-03/15/2018

Attention Ambulance Providers: Non-Emergency Ground Transportation (Posted 2/6/18)
02/01/2018-03/04/2018

Revised Provider Manual Chapters (Updated 2/1/18)
01/30/2018-02/28/2018

Attention Methadone Clinic Providers: DSS Behavioral Health Clinic Regulations Posted (Posted 1/31/18)
01/24/2018-02/28/2018

Electronic Visit Verification Implementation Important Message (Posted 1/24/18)
01/19/2018-02/23/2018

Attention: Methadone Maintenance Clinic Providers (Posted 1/19/18)
01/12/2018-03/01/2018

Attention Dental Providers: Annual Dental Benefit Maximum (Posted 1/12/18)
01/12/2018-02/09/2018

National Correct Coding Initiative (NCCI) - Medically Unlikely Edits (MUE) Review Process (Posted 1/12/18)
01/10/2018-02/13/2018

Hospital Monthly Important Message (Updated 1/10/18)
01/09/2018-01/11/2018

Attention Providers: EFT & 835 Delay (Posted 1/9/18)
01/05/2018-02/01/2018

Attention Dental Providers: Annual Dental Benefit Maximum (Posted 1/5/18)
01/03/2018-01/05/2018

Attention Providers: Office Closure Notification (Posted 1/4/18)
01/02/2018-03/31/2018

Attention Providers: Fee Schedule Update Notification (Posted 1/2/18)
  
+ 2017 Important Messages Archived
  
+ 2016 Important Messages Archived
  
+ 2015 Important Messages Archived
  
+ 2014 Important Messages Archived
  
- 2018 RA Banner Announcements Archived
Banner Effective DateProvidersBanner Page Announcement
09/07/2018-09/14/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially paid and posted one of the following informational Ordering, Prescribing, Referring (OPR) Explanation of Benefit (EOB) codes, but for which the provider in question has since successfully enrolled in the Connecticut Medical Assistance Program (CMAP): EOB Code 0237-PRESCRIBING PROVIDER IS A STUDENT OR RESIDENT AND MUST BE ENROLLED TO PRESCRIBE EOB Code 0027-CLAIM BYPASSED EDIT 0207 DUE TO PPE AUTO-PA EOB Code 0207-PRESCRIBER NOT ENROLLED EOB Code 0028-PRESCRIBING PROVIDER IN PROCESS OF ENROLLING EOB Code 1040-ORDERING/REFERRING/ATTENDING PROVIDER IS NOT ENROLLED ON DATE OF SERVICE These claims will appear on the September 11, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
09/07/2018-09/14/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9 digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the September 11, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefits (EOB) code 8239 "ACA CLIENT TEMP ID REPLACED WITH CMAP ID. NEW CLAIM WILL BE SYSTEMATICALLY GENERATED". The new claims will also appear on the September 11, 2018 RA with an ICN beginning with region code 27.
09/07/2018-09/14/2018Attention Select Clinic ProvidersAttention Select Clinic Providers. PERFORMING PROVIDER REQUIRED: Family Planning Clinics, School Based Health Clinics and Medical Clinics are reminded that all performing providers employed by or contracted with Family Planning Clinics, School Based Health Clinics and Medical Clinic providers who render services to HUSKY Health clients must be enrolled in the Connecticut Medical Assistance Program and be associated to the Clinic. The Department of Social Services will require all claims to be submitted with the performing provider's National Provider Identifier (NPI) effective for date of service November 1, 2018 and forward. DXC Technology has identified claims with dates of service April 1, 2018 through July 31, 2018 where the performing provider's NPI is not present on the Clinic claim. DSS is allowing a post and pay period for claims to bypass edits that would normally cause claims to deny if the performer's NPI is missing or invalid or not associated to the Clinic's NPI with dates of service through October 31, 2018. Providers are encouraged to use the post and pay timeframe to ensure that all your performing providers are enrolled with the CMAP and that they have been associated to the Clinic's NPI. Effective with dates of service November 1, 2018 and forward, claims will no longer post and pay; instead, they will deny if a valid performing provider's NPI is not present on the claim. Providers may reference Provider Bulletin PB 2018-56 for additional information.
09/07/2018-09/14/2018Attention PCMH + ProvidersAttention PCMH + Providers. PCMH + ADD ON PAYMENT: As PCMH + Wave 2 contracts have been finalized, ongoing monthly add on payments will resume and will be posted to the September 11, 2018 Remittance Advice (RA). Providers will also see retroactive add on payments for previous months on this RA.
08/24/2018-08/31/2018Attention 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 24, 2018 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your August 28, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
08/24/2018-08/31/2018Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates, or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your August 28, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
08/10/2018-08/16/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9 digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the August 14, 2018 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 14, 2018 RA with an ICN beginning with region code 27.
07/20/2018-07/27/2018Attention 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 24, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
07/20/2018-07/27/2018Attention Outpatient HospitalsAttention Outpatient Hospitals. REPROCESSED THIS CYCLE: DXC Technology identified an issue with behavioral health outpatient claims that processed without tying to a Prior Authorization (PA). DXC Technology has identified and reprocessed outpatient claims for dates of service between April 26, 2018 and June 15, 2018 with the following procedure codes without PA: 90785, 90792, 90832-90834, 90836-90838, 90846-90847, 90849 and Q4172. If there was no PA on file, the outpatient claims will deny with Explanation of Benefits (EOB) code 3003 "Procedure Code Requires PA". The claims were adjusted in the July 20, 2018 claim cycle and will appear on your July 24, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
07/06/2018-07/13/2018Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: DXC Technology identified an issue with claims not setting the National Correct Coding Initiative (NCCI) audits. These claims processed between January 16, 2018 and March 6, 2018. Claims that would have processed differently due to NCCI auditing were adjusted in the July 6, 2018 claim cycle and will appear on your July 10, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52. They will post Explanation of Benefit (EOB) code 5924 "Claim denied, CCI greater and lesser procedures are not covered on same date of service" or EOB code 5926 "CCI column 2 code was billed on the same date as previous column 1 or mutually exclusive code".
07/06/2018-07/13/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9 digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the July 10, 2018 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 10, 2018 RA with an ICN beginning with region code 27.
07/06/2018-07/13/2018Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: DXC Technology has identified a claims processing issue that impacted Behavioral Health claims where units were decrementing from the incorrect Prior Authorization (PA). This issue impacted claims with procedure codes 99201 - 99205 and 99211 - 99215 for dates of service from December 12, 2017 through May 1, 2018. DXC Technology has made system updates that will now allow claims to process and/or reprocess and decrement the appropriate PA. If no PA exists for the non T1015 service submitted on the claim, the claim will deny for Explanation of Benefit (EOB) code 3003 - "Prior Authorization is Required for the Payment of this Service". The new claims will appear on the July 10, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27. Reprocessed claims will appear on the July 10, 2018 RA with an ICN beginning with region code 52.
06/22/2018-06/29/2018Attention 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 26, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/22/2018-06/29/2018Attention Select PCMH Primary Care ProvidersAttention Select 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 26, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/22/2018-06/29/2018Attention Select Primary Care ProvidersAttention Select Primary Care Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims for providers who were retroactively approved for the HUSKY Health Primary Care Increased Payments policy. The impacted claims have been reprocessed and will appear on your June 26, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
06/22/2018-06/29/2018Attention Select ProvidersAttention Select Providers. CLAIMS PROCESSING ISSUE: The Department of Social Services (DSS) has identified an issue which inadvertently removed the facility paystart authorization segment. The result is that providers may have received claim denials with Explanation of Benefit (EOB) code 1024 "Provider is not authorized to bill for this client". The issue has been corrected and providers should resubmit their claims.
06/22/2018-06/29/2018Attention Outpatient HospitalsAttention Outpatient Hospitals. REPROCESSED THIS CYCLE: DXC Technology previously identified an issue with outpatient therapy claims that paid over the therapy flat rate due to duplicate payment for one date of service. Outpatient therapy claims for dates of service between July 1, 2016 and April 24, 2018 with Revenue Center Codes (RCCs) 421, 424, 431, 434, 441 and 444 that paid more than the flat rate were adjusted and appear on your June 26, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
06/22/2018-06/29/2018Attention Inpatient HospitalsAttention Inpatient Hospitals. REPROCESSED THIS CYCLE: DXC Technology previously identified inpatient DRG claims that paid at the incorrect DRG code, DRG weight or organ transplant rate. DXC has reprocessed the inpatient claims that paid differently due to DRG code, DRG weight or organ transplant rate changes in the June 22, 2018 claim cycle and they will appear on your June 26, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
06/08/2018-06/15/2018Attention Select Skilled Nursing FacilitiesAttention Select Skilled Nursing Facilities. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the June 12, 2018 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your June 12, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
06/08/2018-06/15/2018Attention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Community First Choice (CFC) and Home Health Service ProvidersAttention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Community First Choice (CFC) and Home Health Service Providers. REPROCESSED THIS FINANCIAL CYLE: As communicated to providers in a previous banner page message on the March 27, 2018 Remittance Advice (RA), Connecticut Community Care (CCCI) has restored Prior Authorizations (PAs) which previously caused region 24 claims, dating back to 2013, to deny in the March 8, 2018 financial cycle for Explanation of Benefits (EOB) code 3003 - "Procedure Code requires Prior Authorization (PA)" or EOB code 3016 - "Service not covered under Care Plan". The impacted claims have been identified and reprocessed, and will appear on your June 12, 2018 RA with an Internal Control Number (ICN) beginning with a region code 27 or 52.
06/08/2018-06/15/2018Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: DXC Technology has identified a claims processing issue that impacted Behavioral Health claims where units were decrementing from the incorrect Prior Authorization (PA). This issue impacted claims with procedure codes 99201 - 99205 and 99211 - 99215 for dates of service between May 1, 2016 and December 12, 2017. DXC Technology has made system updates that will now allow claims to process and/or reprocess and decrement the appropriate PA. If no PA exists for the non T1015 service submitted on the claim, the claim will deny for Explanation of Benefit (EOB) code 3003 - "Prior Authorization is Required for the Payment of this Service". The new claims will appear on the June 12, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27. Reprocessed claims will appear on the June 12, 2018 RA with an ICN beginning with region code 52.
06/08/2018-06/15/2018Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the June 12, 2018 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your June 12, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
06/08/2018-06/15/2018Attention Select Dental FQHC ProvidersAttention Select Dental FQHC Providers. REPROCESSED THIS CYCLE: DXC Technology has identified a claims processing issue where claims submitted by Dental FQHC providers were paying over the annual dental benefit limit for clients without requiring a Prior Authorization. The issue has been fixed and the impacted claims have been adjusted to post the Explanation of Benefits (EOB) code 6250 - "Dental Annual Benefit Limit Exceeded" at the appropriate detail(s). The adjusted claims will appear on your June 12, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 50.
06/08/2018-06/15/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9 digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the June 12, 2018 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 12, 2018 RA with an ICN beginning with region code 27.
06/08/2018-06/15/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially paid and posted one of the following informational Ordering, Prescribing, Referring (OPR) Explanation of Benefit (EOB) codes, but for which the provider in question has since successfully enrolled in the Connecticut Medical Assistance Program (CMAP): EOB Code 0237-PRESCRIBING PROVIDER IS A STUDENT OR RESIDENT AND MUST BE ENROLLED TO PRESCRIBE EOB Code 0027-CLAIM BYPASSED EDIT 0207 DUE TO PPE AUTO-PA EOB Code 0207-PRESCRIBER NOT ENROLLED EOB Code 0028-PRESCRIBING PROVIDER IN PROCESS OF ENROLLING EOB Code 1040-ORDERING/REFERRING/ATTENDING PROVIDER IS NOT ENROLLED ON DATE OF SERVICE These claims will appear on the June 12, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
05/18/2018-05/25/2018Attention Birth to Three ProvidersAttention Birth to Three Providers. REMINDER EFFECTIVE FOR DATES OF SERVICE MAY 16, 2018 AND FORWARD: Claim details submitted without the practitioners Employer Identification Number (EIN), for procedure codes T1023, T1027, T1028, T2024 and H2014 will deny with Explanation of Benefits (EOB) code 1803 - "SOCIAL SECURITY NUMBER/EMPLOYER'S IDENTIFICATION NUMBER IS MISSING OR INVALID". A valid EIN is a nine digit number containing the practitioner's three to five digit EIN preceded with leading zeros. Please Note: Claim details with dates of service prior to May 16, 2018 for procedure codes T1023, T1027, T1028, T2024 and H2014 submitted without the practitioners EIN will continue to post and pay with EOB code 5000 "POSSIBLE DUPLICATE OF A PAID CLAIM OR A CLAIM THAT IS CURRENTLY IN PROCCESS", or EOB code 5001 "EXACT DUPLICATE OF A PAID CLAIM OR A CLAIM THAT IS CURRENTLY IN PROCCESS".
05/18/2018-05/25/2018Attention 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 22, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
05/18/2018-05/25/2018Attention 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 22, 2018 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your May 22, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
05/18/2018-05/25/2018Attention PCMH+ ProvidersAttention PCMH+ Providers. PCMH+ ADD ON PAYMENT DELAY: Add on payments for providers participating in the PCMH+ program for the month of May 2018 have been delayed pending signature of PCMH+ Wave 2 contracts. Providers should expect to see payments on a future remittance advice (RA). A banner page message will be posted when those payments are released.
05/18/2018-05/25/2018Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the May 22, 2018 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your May 22, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
05/18/2018-05/25/2018Attention Birth to Three ProvidersAttention Birth to Three Providers. NEW REMITTANCE ADVICE (RA) FORMAT: Your Remittance Advice (RA) for financial cycles dated May 22, 2018 and forward will now be available in the "Comma Separated Values" (CSV) format. A CSV file type can be opened in Microsoft Excel or other spreadsheet programs to allow providers to sort the file and search for specific claim approvals and denials. To access your RA in the CSV format, go to the www.ctdssmap.com Web site and log onto the secure Web portal. Under "Trade Files", choose "Downloads" from the drop down menu. Select "CSV" from the "Transaction Type" on the File Download Search screen. This will populate the current files available to download.
05/10/2018-05/17/2018Attention DDS Autism, Comprehensive, Individual/Family Services (IFS) and Employment and Day Support Billing ProvidersAttention DDS Autism, Comprehensive, Individual/Family Services (IFS) and Employment and Day Support Billing Providers. REPROCESSED THIS CYCLE: DXC Technology will run a special mass adjustment financial cycle beginning May 10, 2018 to reprocess DDS Autism, Comprehensive, IFS and Employment and Day Support claims. These claims will appear on the May 15, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 55.
05/04/2018-05/09/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9 digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the May 8, 2018 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 8, 2018 RA with an ICN beginning with region code 27.
05/04/2018-05/09/2018Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the May 8, 2018 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your May 8, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
05/04/2018-05/09/2018Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: DXC Technology has identified a claims processing issue that impacted Behavioral Health claims where units were decrementing from the incorrect Prior Authorization (PA). This issue impacted claims with procedure codes 90832 and 90853 for dates of service between May 1, 2016 and December 12, 2017. DXC Technology has made system updates that will now allow claims to process and/or reprocess and decrement the appropriate PA. If no PA exists for the non T1015 service submitted on the claim, the claim will deny for Explanation of Benefit (EOB) code 3003 - "Prior Authorization is Required for the Payment of this Service". The new claims will appear on the May 8, 2018 RA with an ICN beginning with region code 27. Reprocessed claims will appear on the May 8, 2018 RA with an ICN beginning with region code 52.
05/04/2018-05/09/2018Attention 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 8, 2018 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your May 8, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
04/20/2018-04/27/2018Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the April 20, 2018 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your April 24, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
04/20/2018-04/27/2018Attention 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 20, 2018 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your April 24, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
04/20/2018-04/27/2018Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates, or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your April 24, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
04/06/2018-04/13/2018Attention Select ProvidersAttention Select Providers. EHR INCENTIVE PAYMENT RECOUPMENT ON YOUR REMITTANCE ADVICE: The Department of Social Services (DSS) has performed an audit of the EHR Incentive Payments paid out to you in the past and have recouped the payments due to adverse findings. The recoupment has created an Accounts Receivable (A/R) which will appear in the Financial Transactions section of your April 10, 2018 Remittance Advice. The information for the A/R will include the amount of the A/R, the reason code 8511 - Medicaid EHR incentive recoupment, the provider's name if different than the payee and the Program Year for the incentive that is being recouped displayed as 01/01/YYYY.
04/06/2018-04/13/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9 digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the April 10, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefits (EOB) code 8239 "ACA CLIENT TEMP ID REPLACED WITH CMAP ID. NEW CLAIM WILL BE SYSTEMATICALLY GENERATED". The new claims will also appear on the April 10, 2018 RA with an ICN beginning with region code 27.
04/06/2018-04/13/2018Attention 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 6, 2018 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your April 10, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
04/06/2018-04/13/2018Attention Select Home Health ProvidersAttention Select Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the April 6, 2018 claims cycle. The recoupments are related to a Home Health settlement with CMS and will appear on your April 10, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
03/23/2018-03/30/2018Attention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Community First Choice (CFC) and Home Health Service ProvidersAttention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Community First Choice (CFC) and Home Health Service Providers. UPDATE ON CLAIMS REPROCESSED IN THE MARCH 14, 2018 FINANCIAL CYCLE: Claims were reprocessed in the March 14, 2018 financial cycle due to updates made to prior authorizations (PAs), impacting some claims dating back to 2013. Connecticut Community Care Inc. (CCCI) is working to restore the PAs and, once complete, DXC Technology will resubmit the claims that previously denied due to Explanation of Benefits (EOB) code 3003 - "Procedure Code requires Prior Authorization (PA)" or EOB code 3016 - "Service not covered under Care Plan." DXC Technology does not currently have a date when this will occur, however, providers will be notified via a Banner Page message for the cycle in which the claims will be reprocessed.
03/23/2018-03/30/2018Attention 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, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/23/2018-03/30/2018Attention Primary Care ProvidersAttention Primary Care Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims for providers who were retroactively approved for the HUSKY Health Primary Care Increased Payments policy. The impacted claims have been reprocessed and will appear on your March 27, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
03/23/2018-03/30/2018Attention 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 27, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/23/2018-03/30/2018Attention Department of Developmental Services (DDS) ProvidersAttention Department of Developmental Services (DDS) Providers. REPROCESSED THIS CYCLE: DXC Technology will be reprocessing a subset of claims previously rate mass adjusted in the February 23, 2018 financial cycle to capture additional rate changes. In addition, MFP IFS/Comprehensive, DDS Comprehensive and DDS IFS Waiver claims, previously processed in the February 23, 2018 rate mass adjustment cycle, will be reprocessed to pay allowed greater than billed, with a subset of these claims also reflecting additional rate changes. As a result, all reprocessed DDS claims may pay differently than previously paid and will appear on the March 27, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 55.
03/23/2018-03/30/2018Attention Skilled Nursing Facilities and Home Health ProvidersAttention Skilled Nursing Facilities and Home Health Providers. RECOUPMENT TRANSACTIONS: The Department of Social Services (DSS) has completed a Centers for Medicare & Medicaid Services (CMS) financial transaction settlement in the March 23, 2018 claims cycle. The recoupments are related to a Home Health and Skilled Nursing Facility settlement with CMS and will appear on your March 27, 2018 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
03/09/2018-03/16/2018Attention Home Health ProvidersAttention Home Health Providers. REPROCESSED THIS CYCLE: DXC Technology has identified claims with dates of service between February 14, 2018 and March 1, 2018 where claims for Revenue Center Codes (RCC), 424, 434 and 444 for HUSKY C clients denied in error with the Explanation of Benefits (EOB) code 4142 - "Billing provider type/provider specialty restriction for revenue center code under benefit plan" due to an internal change made to the effective date of the RCCs under the client's benefit plan. The effective date of the RCCs under the benefit plan for the impacted clients has been corrected and all affected claims have been systematically reprocessed. These reprocessed claims will appear on the March 13, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52.
03/09/2018-03/16/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9 digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the March 13, 2018 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 13, 2018 RA with an ICN beginning with region code 27.
03/09/2018-03/16/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially paid and posted one of the following informational Ordering, Prescribing, Referring (OPR) Explanation of Benefit (EOB) codes, but for which the provider in question has since successfully enrolled in the Connecticut Medical Assistance Program (CMAP): - EOB Code 0237-PRESCRIBING PROVIDER IS A STUDENT OR RESIDENT AND MUST BE ENROLLED TO PRESCRIBE - EOB Code 0027-CLAIM BYPASSED EDIT 0207 DUE TO PPE AUTO-PA - EOB Code 0207-PRESCRIBER NOT ENROLLED - EOB Code 0028-PRESCRIBING PROVIDER IN PROCESS OF ENROLLING - EOB Code 1040-ORDERING/REFERRING/ATTENDING PROVIDER IS NOT ENROLLED ON DATE OF SERVICE These claims will appear on the March 13, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
03/09/2018-03/16/2018Attention Select ProviderAttention Select Provider. REPROCESSED THIS CYCLE: DXC Technology had identified a claims processing issue that impacted Behavioral Health FQHC claims where units were decrementing from the incorrect Prior Authorization (PA). This issue impacted claims with procedure codes 90791-90792, 90785, 90834-90837 and 99211-99215 for dates of service between May 5, 2016 and December 12, 2017. This corrective action will now allow claims to reprocess and decrement the appropriate PA. If no PA exists for the non T1015 service submitted on the claim and there is no PA available at all, the claim is now denying correctly for Explanation of Benefit (EOB) code 3003 "Prior Authorization is Required for the Payment of this Service". If there is PA available although not for the non T1015 service on the claim, we will decrement whatever PA has available units. These reprocessed claims will appear on your March 13, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 52.
03/09/2018-03/16/2018Attention Select ProviderAttention Select Provider. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under the incorrect provider specialty, resulting in payment using the Melded Mental Health (MMH) rate instead of the Enhanced Care Clinic (ECC) rate. This issue impacted claims that were processed between November 17, 2017 and January 19, 2018. These claims will be reprocessed to pay the ECC rate and will appear on your March 13, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52. As of January 22, 2018, the provider specialty was updated and newly submitted claims are now paying correctly using the ECC rate.
02/23/2018-03/02/2018Attention Department of Developmental Services (DDS) ProvidersAttention Department of Developmental Services (DDS) Providers. REPROCESSED THIS CYCLE: Rate Mass Adjustments will take place in the February 23, 2018 financial cycle for claims with interim rates beginning July 1, 2015 through June 30, 2016 and July 1, 2016 forward for State Operated Intermediate Care Facility for the Intellectually Disabled (ICF/IID's), and State Operated and Private Community Living Arrangement (CLA) residence for procedure code 9764Z, State Operated and Private Employment and Day Support for procedure codes T2018 and T2020, and Targeted Case Management for procedure code 9780Z. These claims will appear on the February 27, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with a region code 55.
02/23/2018-03/02/2018Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates, or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your February 27, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
02/09/2018-02/16/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9 digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the February 14, 2018 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 14, 2018 RA with an ICN beginning with region code 27.
02/09/2018-02/16/2018Attention Ambulance Ground ProvidersAttention Ambulance Ground Providers. REPROCESSED THIS CYCLE: Due to the implementation of the new Non-Emergency Medical Transportation (NEMT) contract and the delay in the contractor, Veyo, being able to provide the Department of Social Services (DSS) with a Prior Authorization (PA) file for NEMT ground ambulance trips, trips with a date of service January 1, 2018 and ongoing were being suspended with Explanation of Benefit (EOB) code 3003 "Prior Authorization is Required for Payment of this Service" or EOB code 4801 "No Contract for Billed Procedure". These suspended claims will be processed without the PA being on file in the February 9, 2018 claim cycle and will appear on your February 14, 2018 Remittance Advice.
01/19/2018-01/26/2018Attention Providers of Acquired Brain Injury (ABI), Connecticut Home Care (CHC), Personal Care Assistant (PCA) Waiver and Home Health ServicesAttention Providers of Acquired Brain Injury (ABI), Connecticut Home Care (CHC), Personal Care Assistant (PCA) Waiver and Home Health Services. MONTHLY WAIVER CLAIMS REPROCESSING: DXC Technology will be recouping and reprocessing a large number of claims impacted by changes made to ABI, CHC and PCA Prior Authorizations (PAs) by Connecticut Community Care (CCCI) due to the implementation of their new computer system. These claims will be recouped and reprocessed in either the first or second cycle of January 2018 and will appear on either the January 9, 2018 or January 23, 2018 Remittance Advice (RA). Claims impacted by a PA change will be recouped, with an Internal Control Number (ICN) beginning with a region code 52, and Explanation of Benefits (EOB) code of 8236 "CLAIM RECOUPED DUE TO A PA CHANGE". Claims will be reprocessed in the same cycle, with an ICN beginning with a region code 24 and EOB code 8238 "CLAIM SYSTEMATICALLY REPROCESSED DUE TO A PA/SERVICE ORDER CHANGE". As a reminder, only those claims recouped and reprocessed with a financial impact to the provider (i.e. the reprocessed claim denied, paid more or paid less than the claim recouped) will appear on the provider's RA. Region code 24 claims should be reviewed by the provider to ensure a PA is in place for the services provided and that the service billed is the service authorized. PA discrepancies should be reported to the Access Agency for CHC and PCA Waiver clients or to the Case Management Agency for ABI Waiver clients. Once the discrepancy, if any, has been resolved, the impacted claims must be resubmitted by the provider. Please Note: Reprocessed claims with no financial impact (i.e. the reprocessed claim paid the same as the recouped claim) will not appear on the provider's RA. However, claims will be viewable via the provider's secure Web Portal account and will appear on the providers ASC X12N 835 Health Care Payment/Advice with an EOB code 8237 "CLAIM SYSTEMATICALLY REPROCESSED DUE TO PA CHANGE INFORMATION ONLY".
01/19/2018-01/26/2018Attention Select Home Health ProvidersAttention Select Home Health Providers. AUTHORIZATION ISSUE: An issue has been identified that impacted authorizations containing procedure code G0162 sent to Sandata by DXC Technology on or before January 11, 2018. Duplicate authorization numbers appear in Santrax that were created in error by DXC Technology. For each authorization submitted to Sandata that contained procedure code G0162, a second authorization with the same authorization number was submitted containing an invalid procedure code. The erroneous authorizations will soon be voided in Santrax by DXC Technology. These authorizations were not issued by the Access Agencies and do not appear on the ctdssmap.com Web site. Please refer to the DSS Secure Web site should you question which authorization is valid. We apologize for the inconvenience this may have caused and appreciate your patience as we resolve this error.
01/19/2018-01/26/2018Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates, or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your January 23, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
01/19/2018-01/26/2018Attention Select ABI, PCA, CHC and Home Health ProvidersAttention Select ABI, PCA, CHC and Home Health Providers. RECOUP AND REPROCESS: DXC Technology has recouped and reprocessed claims in both the January 5, 2018 and January 19, 2018 claim cycles due to changes to prior authorizations submitted by Access Agencies. A limited number of reprocessed claims either partially paid or fully denied for Explanation of Benefit (EOB) Code 3003 "Prior authorization is required for payment of this service" in error. The Internal Control Number (ICN) for these claims begin with region code 24. DXC technology will resolve these denials by resubmitting the denied claims and recouping and reprocessing the partially paid claims. This corrective action will take place in the January 19, 2018 claim cycle and the reprocessed claims will appear on your January 23, 2018 Remittance Advice (RA) with an ICN beginning with region code 27. We apologize for the inconvenience this has caused.
01/19/2018-01/26/2018Attention Select Dental ProvidersAttention Select Dental Providers. REPROCESSED THIS CYCLE: The Department of Social Services made a minor system update for the new Dental Annual Benefit Limit that went into effect as of January 1, 2018. As a result, a handful of claims that initially processed and posted Explanation of Benefits (EOB) Code 6250 "Dental Annual Benefit Limit Exceeded" on one of its details were identified and reprocessed to include the update. The reprocessed claims do not post EOB Code 6250 on any detail and will appear on your January 23, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 50.
01/05/2018-01/12/2018Attention All ProvidersAttention All Providers. REPROCESSED THIS CYCLE: DXC Technology has identified and reprocessed claims which initially processed and paid under a temporary client ID as described in Provider Bulletin 2014-29. The claims were reprocessed to reflect the client's true (permanent) 9 digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the January 9, 2018 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 9, 2018 RA with an ICN beginning with region code 27.
01/05/2018-01/12/2018Attention Providers of Acquired Brain Injury (ABI), Connecticut Home Care (CHC) and Personal Care Assistant (PCA) Waiver ServicesAttention Providers of Acquired Brain Injury (ABI), Connecticut Home Care (CHC) and Personal Care Assistant (PCA) Waiver Services. MONTHLY WAIVER CLAIMS REPROCESSING: DXC Technology will be recouping and reprocessing a large number of claims impacted by changes made to ABI, CHC and PCA Prior Authorizations (PAs) by Connecticut Community Care (CCCI) due to the implementation of their new computer system. These claims will be recouped and reprocessed in either the first or second cycle of January 2018 and will appear on either the January 9, 2018 or January 23, 2018 Remittance Advice (RA). Claims impacted by a PA change will be recouped, with an Internal Control Number (ICN) beginning with a region code 52, and Explanation of Benefits (EOB) code of 8236 "CLAIM RECOUPED DUE TO A PA CHANGE". Claims will be reprocessed in the same cycle, with an ICN beginning with a region code 24 and EOB code 8238 "CLAIM SYSTEMATICALLY REPROCESSED DUE TO A PA/SERVICE ORDER CHANGE". As a reminder, only those claims recouped and reprocessed with a financial impact to the provider (i.e. the reprocessed claim denied, paid more or paid less than the claim recouped) will appear on the provider's RA. Region code 24 claims should be reviewed by the provider to ensure a PA is in place for the services provided and that the service billed is the service authorized. PA discrepancies should be reported to the Access Agency for CHC and PCA Waiver clients or to the Case Management Agency for ABI Waiver clients. Once the discrepancy, if any, has been resolved, the impacted claims must be resubmitted by the provider. Please Note: Reprocessed claims with no financial impact (i.e. the reprocessed claim paid the same as the recouped claim) will not appear on the provider's RA. However, claims will be viewable via the provider's secure Web Portal account and will appear on the providers ASC X12N 835 Health Care Payment/Advice with an EOB code 8237 "CLAIM SYSTEMATICALLY REPROCESSED DUE TO PA CHANGE INFORMATION ONLY".
  
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