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RA Banner Announcements
 
Banner Effective DateProvidersBanner Page Announcement
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 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 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 All ProvidersAttention All Providers. HOLIDAY CLOSURE: Please be advised, the Department of Social Services (DSS) will be closed on Monday, February 12, 2018 in observance of Lincoln's Birthday. DSS will re-open on Tuesday, February 13, 2018. In addition, DSS and DXC Technology will be closed on Monday, February 19, 2018 in observance of the Presidents' Day holiday. Both DSS and DXC Technology offices will re-open on Tuesday, February 20, 2018.
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.
01/19/2018-01/26/2018Attention 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 60% will be recouped in increments of 10% of the A/R amount due over the course of the next 6 payment cycles or until the amount is satisfied. Providers will see the A/R posted under the "Financial Transactions" section of the January 23, 2018 RA.
01/19/2018-01/26/2018Attention 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 claims processing cycles starting with the December 12, 2017 cycle. 20% of the outstanding Accounts Receivable (A/R) is being recouped in the current cycle and the remaining 20% will be recouped in the next payment cycle or until the amount is satisfied. Providers will see the A/R posted under the "Financial Transactions" section of the January 23, 2018 RA.
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.


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