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RA Banner Announcements |
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| Banner Effective Date | Providers | Banner Page Announcement |
| 06/06/2025-06/13/2025 | Attention Select Providers | Attention Select Providers. REPROCESSED THIS CYCLE: For dates of service January 1, 2025 and forward, DSS and Gainwell Technologies have identified and reprocessed professional maternity bundle claims for all clients with TPL designated on the claim. The claims were reprocessed to exclude claim details from the maternity bundle that contain a Third Party Liability (TPL) amount that is greater than zero or a claim adjustment reason code designating a deductible, coinsurance or copayment amount. Previously, only TPL claims with an Other Insurance (OI) paid amount greater than $0 were excluded from the maternity bundle. The reprocess includes claims with a reported $0 OI amount where a coinsurance, copay, or deductible has been found at the header or any of the details on the claim, regardless of the information on the patient's TPL file. For claims with details that span months, only the details with coinsurance, copay, or deductible, will be excluded from the bundle. The reprocessed claims will appear on the June 11, 2025 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52. |
| 06/06/2025-06/13/2025 | Attention All Providers | Attention All Providers. PROVIDER FILE MAINTENANCE: In order to maintain the accuracy and completeness of the Connecticut Medical Assistance Program (CMAP) network, we are requesting all providers update their provider file on a regular basis. The information that you provide is presented in the on-line provider directory at www.ct.gov/husky. Thousands of members statewide rely on the accuracy of this source of information to find a suitable health care provider. Inaccurate addresses, phone numbers, and names may affect a member's ability to contact you. To update your provider profile, the main account administrator can log into their secure Web account from the www.ctdssmap.com Web site and click on the "Demographic Maintenance" tab. Once on the Demographic Maintenance page, the provider can select from options listed as links below the Demographic Maintenance header panel. For instance, you can update your address* if you happen to move to a new location; all you have to do is click on the "Location Name Address" link, select the address to be updated, click on the "Maintain Address" button to type in the new address and then save your changes. You can also add or remove performing providers to your group practice as applicable by clicking on "Maintain Organization Members". For detailed instructions, please refer to Section 10.18 "Provider Demographic Maintenance" in Chapter 10 of the Provider Manual. The chapter is available from the Web site www.ctdssmap.com by clicking on "Publications" under Information, scrolling down to Provider Manuals and then clicking on "Web Portal/AVRS". Providers may contact the Provider Assistance Center at 1-800-842-8440 between the hours of 8:00 AM to 5:00 PM Monday through Friday if further assistance is needed in updating the information from their secure Web portal account.
*There are special instructions for PCMH providers and licensed facilities such as hospitals, pharmacies, and clinic providers for updating their service location or alternate service location addresses. Please refer to the warning messages on the Web pages, as well as Chapter 10 for additional information. |
| 06/06/2025-06/13/2025 | Attention Select Providers | Attention 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 impacted claims were reprocessed to reflect the client's true (permanent) 9-digit Connecticut Medical Assistance Program (CMAP) ID. The claims which processed under a temporary client ID will be recouped and appear on the June 11, 2025 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52 and Explanation of Benefits (EOB) code 8239 "ACA CLIENT TEMP ID REPLACED WITH CMAP ID. NEW CLAIM WILL BE SYSTEMATICALLY GENERATED". New claims will also appear on the June 11, 2025 RA with an ICN beginning with region code 27. |
| 06/06/2025-06/13/2025 | Attention Pharmacy Providers | Attention Pharmacy Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims which initially paid and posted one of the following informational Ordering, Prescribing, Referring (OPR) Explanation of Benefit (EOB) codes, but for which the provider in question has since successfully enrolled in the Connecticut Medical Assistance Program (CMAP):
* EOB Code 0237-PRESCRIBING PROVIDER IS A STUDENT OR RESIDENT AND MUST BE ENROLLED TO PRESCRIBE
* EOB Code 0027-CLAIM BYPASSED EDIT 0207 DUE TO PPE AUTO-PA
* EOB Code 0207-PRESCRIBER NOT ENROLLED
* EOB Code 0028-PRESCRIBING PROVIDER IN PROCESS OF ENROLLING
* EOB Code 1040-ORDERING/REFERRING/ATTENDING PROVIDER IS NOT ENROLLED ON DATE OF SERVICE.
These claims will appear on the June 11, 2025 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52. |
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