Gainwell Technologies is the primary source for responding to provider questions on various aspects of the Connecticut Medical Assistance Program, with the exception of policy dictated by the Department of Social Services (DSS). The Gainwell Technologies Provider Relations team provides many resources to assist providers. This page provides detailed information for each of these resources, such as assistance center phone numbers and Gainwell Technologies claims and correspondence mailing addresses. This page also provides DSS contact information, schedule information, and provider training information.

Gainwell Technologies is the Fiscal Agent under contract with the State of Connecticut Department of Social Services to support the operation of the Medical Assistance Program. Gainwell Technologies' responsibilities include: processing claims, financial refunds and recoupments; issuing payments and remittance advices; performing provider enrollment and re-enrollment; offers a provider call center dedicated to assisting providers with billing questions; providing a dedicated provider relations team to perform provider training and respond to complex program issues; providing a client assistance call center; and providing pharmacy prior authorization service and call center.

Gainwell Technologies maintains the provider Web portal which allows for real-time claim submission and adjudication, online provider enrollment/re-enrollment, inquiries regarding prior authorization submission and inquiry, claims submission and status, client eligibility verification, and other self-service features aimed at increasing access to and improving the efficiency of participating in the Connecticut Medical Assistance Program. In addition, Gainwell Technologies provides an Automated Eligibility Verification System which provides the most current client eligibility information, Prior Authorization information and a Fax on Demand feature.

The Connecticut Department of Social Services (DSS) is responsible for the administration of the Connecticut Medical Assistance Program. In its role as the administrator of the program, DSS interprets the State and Federal laws and regulations, and develops the necessary policies and procedures to implement those regulations. DSS is responsible for policy, procedures, and payment methodology. Questions relating to these areas should be addressed to DSS.

Gainwell Technologies Provider Relations offers free provider training on a bi-monthly basis. If you are a newly enrolled provider in the Connecticut Medical Assistance Program, have new office staff, or simply want to brush up on billing basics, please join us at these scheduled events. For more information on covered topics, the bi-monthly training session schedule, or to obtain a registration form or directions to the facility where the workshop will be held, click here.