Provider Relations


PROVIDER RELATIONS

SWCAA truly values the hard work and efforts of our CHCP Providers. We make every effort to keep you informed of changes and improvements within the CHCP program so that we continue to serve our clients in the most effective manner. The information provided is designed to help Providers more easily access the forms and instructions they need to do business with SWCAA. Please note, Provider enrollment is no longer facilitated by the Access Agency. Providers interested in enrolling or re-enrolling in the CT Home Care Program must follow the enrollment instructions available at Connecticut Medical Assistance Program.

 

HELPFUL CONTACTS

Questions regarding Provider enrollment-

 

Questions regarding Provider Number, billing file uploads

 

Questions regarding specific claim denials

 

 

PROVIDER RESPONSIBILITY

Please note, Providers are responsible to inform SWCAA when a client is unavailable for services. This includes hospitalizations, skilled nursing stays, vacations or any other service break. Claims for dates of service when a client is unavailable should not be billed. Payments for services that are not delivered to the client or unauthorized services may result in audit findings. Any and all changes in condition or concerns regarding the client’s environment should be brought to the care manager’s immediate attention. A list of care managers and regions served is available here for your reference.

 

IMPORTANT CHCP PROVIDER BULLETINS

The following bulletins provide important information to Providers from HP, SWCAA and the Department of Social Services.

Important Message, Qualidigm Personal Care Aide Training Series.

Provider Bulletin PB18-61 Rate Increases.

Important Message, DUR Board Newsletters.

Provider Bulletin 2018-60 September 2018; Reminder of Connecticut Medicaid Coverage of Hospice Benefit.

Important Message, Provider Bulletin PB18-61 Rate Increases is being rescinded.

Connecticut Medical Assistance Program Workshops For Long Term Care Providers.

Important Message, The Medicaid Electronic Health Records Incentive Program.

Important Message, Hospital Monthly Important Message Updated as of 08/15/2018.

Provider Bulletin 2018-56 August 2018; Performing Provider Required for Select Clinic Providers.

Provider Bulletin 2018-55 August 2018; Data Entry Errors for Enhanced Care Clinics under the Connecticut Behavioral Health Partnership.

Provider Bulletin 2018-54 August 2018; Elimination of Co-payments for Behavioral Health Services Rendered to HUSKY B Members under the Connecticut Medical Assistance Program.

Important Message, Welcome to the Connecticut Medical Assistance Program Electronic Visit Verification Implementation.

Important Message, Connecticut Medical Assistance Program Workshop, An In-Depth Review of Your Remittance Advice.

Provider Bulletin 2018-52 August 2018; Electronic Visit Verification (EVV) – Consecutive Services Enhancement.

Provider Bulletin 2018-51 August 2018; 2018 Dental Fee Schedule Update for CDT D1354.

Provider Bulletin 2018-49 August 2018; Streamlining Pharmacy Prior Authorization Requests.

Provider Bulletin 2018-48 August 2018; Clarifying the Discontinuation of a Non-surgical, Permanent Birth Control Device as a Covered Benefit of the HUSKY Health Program.

Provider Bulletin 2018-47 August 2018; Addition of Prior Authorization Requirements for Two Dental Codes.

Important Message, Consecutive Services Enhancement.

Important Message, Connecticut Medical Assistance Program Workshops.

Important Message, Clarification of PB 18-37 Required PCA Training.

Important Message, EVV Implementation Overview.

Important Message, Program Workshops For Home Health Providers.

Important Message, Program Workshop For Dental Providers.

Important Message, Attention Primary Care Providers – Upcoming Continuing Medical Education Conference.

Important Message, MAPIR is now open for Program Year 2018.

Provider Bulletin 2018-34 Reminder July 2018; Attention Providers – Enhancements will be introduced to the Web portal.

Provider Bulletin 2018-41 July 2018; Attention Providers – Rates for Rental Items Used with Continuous Positive Airway Pressure and Respiratory Assist Devices, Bi-level Pressure.

Provider Bulletin 2018-40 July 2018; Attention Providers – Change in Pricing Methodology for Patient Lifts on the MEDS Fee Schedule.

Important Message, Provider Bulletin PB18-32 Supervision of Licensed Master Social Workers is being rescinded.

Important Message, Reporting a Change in Client Condition Functionality Update.

Important Message, Attention Electronic Visit Verification Service Providers – Mobile Visit Verification App Update.

Important Message, Attention Home Health Agencies – Follow-up to the Face-to-Face Requirements for Initial Orders of Home Health Services.

Important Message, 2018 Information Sessions.

Important Message, EVV Implementation Overview.

Important Message, Attention Acquired Brain Injury, Connecticut Home Care Service Providers and Access and Case Management Agencies – Personal Care Assistance Service Authorization Changes and Reminders.

Important Message, EVV Implementation Overview.

Provider Bulletin 2018-37 June 2018; Attention Providers – Homemaker and Companion Agencies, Home Health Agencies.

Provider Bulletin 2018-36 June 2018; Attention Providers – Provider Bulletin PB18-36 Changes to the Connecticut Medicaid Preferred Drug List.

Provider Bulletin 2018-35 June 2018; Attention Providers – Provider Bulletin PB18-35 Documentation Guidelines for Evaluation & Management Services Performed by Students.

Provider Bulletin 2018-33 June 2018; Private Non-Medical Institution (PNMI) Rates for Adult Mental Health Rehabilitation Services.

Provider Bulletin 2018-32 June 2018; Attention Providers – Provider Bulletin PB18-32 Supervision of Licensed Master Social Workers is being rescinded.

Provider Bulletin 2018-31 June 2018; Attention Providers – Provider Bulletin PB18-31 Revised Medicaid (HUSKY) Spend-down Procedures.

Provider Bulletin 2018-30 May 2018; Electronic Claims Submission, Web Remittance Advice, Check, EFT and 835 Schedule.

Provider Bulletin 2018-29 May 2018; Expedited Medicaid Eligibility Processing for Individuals with Medical Emergencies.

Provider Bulletin 2018-27 May 2018; New Proc/Mod List Codes for Nursing Management and Evaluation of the Plan of Care under the Autism, Acquired Brain Injury, Connecticut Home Care and Personal Care Assistance Waiver Programs.

Important Message, Attention All Providers.

Important Message, Revised Provider Manual Chapters.

Important Message, Program Year 2018 Requirements Modified Stage 2.

Provider Bulletin 2018-23 April 2018; New Genetic Testing Prior Authorization Forms.

Provider Bulletin 2018-22 April 2018; Access Requirements for Freestanding Behavioral Health Enhanced Care Clinics under the Connecticut Behavioral Health Partnership.

Important Message, Connecticut Medical Assistance Program Workshop.

Important Message, MAPIR will be Available and Accepting Medicaid Eligible Professionals Attestations for Program Year 2018 in May 2018.

Important Message, Home Health Providers Change in “Katie Beckett” – Model Waiver Claims Processing.

Important Message, Additional Guidance on the Use of the Home Health SOC/ROC and Recertification Service Codes for CHC, ABI, PCA and Autism Waiver Clients.

Important Message, Clinical Quality Measure Requirements for Eligible Professionals under the Medicaid Electronic Health Record Incentive.

Provider Bulletin 2018-17 March 2018; Electronic Visit Verification Enhancement – Alternate Claim Solution.

Important Message, February 2018, Revised Provider Manual Chapters.

Provider Bulletin 2018-15 February 2018; Reductions and Adjustments to Payment for Durable Medical Equipment to Remain Compliant with Federal Law and Addition.

Provider Bulletin 2018-14 February 2018; Changes to Pricing Methodology for Certain Miscellaneous Custom Wheelchair Components Billed under Procedure Code K0108.

Provider Bulletin 2018-05 February 2018; Updates to HUSKY Plus Benefit Limits for Medical Equipment, Devices and Supplies and Therapy Services.

Provider Bulletin 2018-03 February 2018; Peer-to-Peer Review and Reevaluation for Medically Necessary Determinations– Licensure Requirements.

Important Message, February 2018, EVV Implementation Overview.

Important Message, January 2018, Annual Dental Benefit Maximum (Updated 1/12/18).

 

(Older Bulletins)