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RA Banner Announcements
 
Banner Effective DateProvidersBanner Page Announcement
04/09/2021-04/16/2021Attention 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.
04/09/2021-04/16/2021Attention 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 April 13, 2021 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 13, 2021 RA with an ICN beginning with region code 27.
04/09/2021-04/16/2021Attention 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 April 9, 2021 claims cycle. The recoupments are related to a Home Health Agency settlement with CMS and will appear on your April 13, 2021 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
04/09/2021-04/16/2021Attention 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 9, 2021 claims cycle. The recoupments are related to a Skilled Nursing Facility settlement with CMS and will appear on your April 13, 2021 Remittance Advice (RA) under Accounts Receivable with reason code 8407 "CMS Settlement".
04/09/2021-04/16/2021Attention All ProvidersAttention All Providers. NEW EXPLANATION OF BENEFITS (EOB) CODE 2530: The Department of Social Services (DSS) has implemented a new edit for Medicare Crossover claims to ensure that such claims are considered for coinsurance and/or deductible only when the client has Medicare coverage for the dates of service submitted on the claim. EOB Code 2530 - CLIENT DOES NOT HAVE MEDICARE COVERAGE ON CLAIM DATES OF SERVICE will set on a Medicare Crossover claim when the client does not have Medicare coverage for the claim dates of service. The EOB is currently in a post and pay status. However, in the future, a claim will deny when this EOB sets on the claim. DSS will inform the providers when the status of EOB 2530 is changed from post and pay to deny the claim.
04/09/2021-04/16/2021Attention Pharmacy ProvidersAttention Pharmacy Providers. REPROCESSED THIS CYCLE: The Department of Social Services (DSS) notified pharmacy providers via Provider Bulletin PB 2021-25 that effective retroactively for dates of service on and after March 15, 2021, the reimbursement for the COVID-19 vaccine was increased to $40.00 per dose. Gainwell Technologies has identified and reprocessed claims where the billed amount for the vaccine administration was greater than $40.00 and the claim did not pay the retroactive $40 vaccine administration fee. The reprocessed claims will appear on the April 13, 2021 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.


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  • Provider Assistance Center
    toll free at 1-800-842-8440
    1-866-604-3470
    (alternate TTY/TDD line)

  • Client Assistance Center
    toll free at 1-866-409-8430
    1-866-604-3470
    (alternate TTY/TDD line)

  • Pharmacy Prior Authorization
    Assistance Center
    toll free at 1-866-409-8386
    1-866-604-3470
    (alternate TTY/TDD line)
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