Upon completion of an application and receipt of any
necessary follow on documentation, Gainwell Technologies performs a final
validation of the submitted information. If any information is
missing, invalid, or Gainwell Technologies is unable to process the application,
the provider will be notified via letter of the correction or
additional information required. Providers will not be able to
correct or modify completed applications using the Wizard but
will need to submit paper corrections.
Once all information has been provided and is correct, Gainwell Technologies
will submit the completed application to the Department of
Social Services Quality Assurance Unit for approval. The
Department of Social Services returns an approval or denial to
Gainwell Technologies, who then notifies the provider of the final status of the
The Provider Enrollment Approval Notice notifies the provider
of acceptance or successful re-enrollment in the Connecticut
Medical Assistance Program(s), as well as the taxonomy/provider
type/specialty of the enrolled provider and a list of members
within the provider’s organization, if applicable.
The Provider Enrollment Approval Notice supplies information
on Electronic Data interChange options for submitting and
receiving electronic program information, like claim submission
and remittance advices.
If an enrollment/re-enrollment application is denied, a
Provider Enrollment/Re-enrollment Rejection Notice is sent to
the provider. This letter outlines the reason(s) the application
was denied. A provider receiving a denial from Department of
Social Services' Quality Assurance Unit must follow the
instructions for responding to the denial as outlined in the
letter. In order to reapply to the Connecticut Medical
Assistance Program, a provider must once again follow the
enrollment process described previously.
Providers are assigned a re-enrollment due date based on the
date the last application was executed. Re-enrollment periods
vary by provider type and are displayed in Section 3.4 of the
Provider Manual. Refer to Section 3.4 for additional information
on re-enrollment procedures.
Providers are notified via a letter when it is time to
re-enroll. If providers do not respond to requests to
re-enroll, Gainwell Technologies will generate and mail to the provider a
reminder letter before dis-enrolling the provider from the
Connecticut Medical Assistance Program.