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RA Banner Announcements
 
Banner Effective DateProvidersBanner Page Announcement
12/07/2018-12/14/2018Attention 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 December 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 December 11, 2018 RA with an ICN beginning with region code 27.
12/07/2018-12/14/2018Attention 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 December 11, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52.
12/07/2018-12/14/2018Attention Select ProvidersAttention Select Providers. FTC/POS 19 CLAIMS REPROCESSING FINANCIAL IMPACT: DXC Technology identified and reprocessed claims with dates of service January 1, 2016 and forward, where the systematic logic that prices details eligible under the HUSKY Health Primary Care Increased Payments Policy did not appropriately reimburse at the facility rate when Facility Type Code (FTC)/Place of Service (POS) 19 was reported at the detail. As a result, claims eligible under the HUSKY Health Primary Care Increased Payments Policy billed with FTC/POS 19 were, in error, reimbursed at the non-facility rate. Claims with dates of service prior to January 1, 2016, where FTC/POS 19 was reported on the detail prior to its effective date, were recouped. The impacted claims were adjusted and appeared on your December 12, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52. To lessen the financial impact of the reprocessing on providers, the Department of Social Services (DSS) decided to recoup the funds in increments of 20% over several claim cycles starting with the December 12, 2017 cycle. The last 20% of the outstanding Accounts Receivable (A/R) is being recouped in the current claim cycle. Providers will see the A/R posted under the "Financial Transactions" section of the December 11, 2018 RA.
12/07/2018-12/14/2018Attention Select ProvidersAttention Select Providers. FTC/POS 19 CLAIMS REPROCESSING FINANCIAL IMPACT: DXC Technology identified and reprocessed claims with dates of service January 1, 2016 and forward, where the systematic logic that prices details eligible under the HUSKY Health Primary Care Increased Payments Policy did not appropriately reimburse at the facility rate when Facility Type Code (FTC)/Place of Service (POS) 19 was reported at the detail. As a result, claims eligible under the HUSKY Health Primary Care Increased Payments Policy billed with FTC/POS 19 were, in error, reimbursed at the non-facility rate. Claims with dates of service prior to January 1, 2016, where FTC/POS 19 was reported on the detail prior to its effective date, were recouped. The impacted claims were adjusted and appeared on your December 12, 2017 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 52. To lessen the financial impact of the reprocessing on providers, the Department of Social Services (DSS) decided to recoup the funds in increments of 10% over several claims processing cycles starting with the December 12, 2017 cycle. 10% of the outstanding Accounts Receivable (A/R) is being recouped in the current cycle and the remaining 40% will be recouped in increments of 10% of the A/R amount due over the course of the next payment cycle or until the amount is satisfied. Providers will see the A/R posted under the "Financial Transactions" section of the December 11, 2018 RA.
12/07/2018-12/14/2018Attention All ProvidersAttention All Providers. HOLIDAY CLOSURE: Please be advised, the Department of Social Services (DSS) and DXC Technology will be closed on Tuesday, December 25, 2018 in observance of Christmas and on Tuesday, January 1, 2019 in observance of the New Year.
12/07/2018-12/14/2018Attention 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.
12/07/2018-12/14/2018Attention EVV Service ProvidersAttention EVV Service Providers. CONFIRMED VISITS: Claims processed between November 21, 2018 and December 5, 2018 may have inappropriately denied for Explanation of Benefit (EOB) code 3327 - "Confirmed Visit Not Found" or EOB code 3328 - "Confirmed visit units are exceeded" when the claim was submitted outside of the Santrax system. This issue was resolved on December 5, 2018. The impacted claims were either resubmitted or adjusted and will appear on your December 11, 2018 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52. We apologize for any inconvenience this may have caused.


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