Chapter 1: Contact Information and Member Eligibility
Chapter Contents:
- Provider Services Call Center
- Mailing Addresses
- HUSKY Health Dental Plan Website
- Client Eligibility and Treatment History
- Provider Referrals
- DSS – CT Medical Assistance Program (CMAP) Website
- Client Eligibility
Provider Services Call Center
Our Member Services Call Center is here to provide you and your patients with assistance in securing dental services. The Call Center is staffed Monday – Friday from 8:00 AM to 5:00 PM. Providers may call the following numbers for assistance:
Mailing Addresses
Prior Authorization and Post Procedure Authorizations Requests for Non–Orthodontic Services:
CT Medicaid Prior Authorizations
C/O Dental Benefit Management/BeneCare
555 City Avenue
Bala Cynwyd, PA 19004
Prior Authorization for Orthodontic Treatment Requests:
Orthodontic Case Review
C/O BeneCare Dental Plans
195 Scott Swamp Road, Suite 101
Farmington, CT 06032
HUSKY Health Dental Plan – CTDHP Website – www.ctdhp.org
Providers may access the CTDHP website at www.ctdhp.org. Simply click on Dental Providers at the top. The Providers section of the website has both public information and a secure portal. This area of the site provides general information resources including forms, educational brochures and more.
The Providers’ secure portal is used to access Protected Health Information regarding Prior Authorization status and Client History by date of service. Providers will need to use their National Provider Identifier (NPI) and Federal Tax Identification Number (TIN) to access the secure area of the website.
Click on the link labeled “Provider Login.” To sign into the secure portal, you will need your Billing NPI number as well as your Federal Tax ID number. Enter the information in the boxes provided.
Once you have successfully entered your identifying information, you will
see this screen populated with your personal information:
You may now use the links on this page and on the left of this page to check client eligibility, treatment history and find additional participating providers or upload information to BeneCare.
Client Eligibility and Treatment History
To check Client Eligibility and Treatment History follow the steps outlined below: Click on the link labeled Client Inquiry. You will then see the following screen:
For each member / client that you wish to check eligibility for, please enter the client’s Medicaid ID number, Date of Birth, and click on the “Add Client” button.
As you add clients to the eligibility report, they will appear on the screen in list format. When you have finished adding clients to the report, you can either click on the “Remove” button to delete a client from the report, or click on the hyperlink in the yellow box labeled “Click Here” to run the report.
The screen will return the current day’s eligibility status as well as a listing of historical dental procedures on file. In the case of an adult client, the report will also show the amount of dental benefit that has been used towards the annual $1,000 maximum benefit. See example below:
Provider Referrals
Providers will also have access to a locator tool which can be used to find a general dentist or specialist in a provider or client’s area. To access the tool, click on Provider Referrals on the left side of the page. The following screen will appear:
Fill in the:
- Client ID
- Client Date of Birth
- Zip Code and preferences for specialty, distance, language and special needs, and then click Search.
If a search returns no results, it may be necessary to increase the radius and/or refine the selection criteria for language or special needs.
Department of Social Services Website – CT Medical Assistance Program (CMAP)
DSS contracts with Gainwell to maintain the website for the CT Medical Assistance Program (CMAP). It can be accessed at: www.ctdssmap.com.
The site provides important information to health care providers about the Connecticut Medical Assistance Program. This site contains a wealth of resources for providers including enrollment, billing manuals, bulletins,
program regulations, plus information on Electronic Data Interchange and the Automated Eligibility Verification System.
The site has both public-facing and a secure portal. The public-facing part of the site important information, provider and trading partner links, pharmacy information, provider publications, provider enrollment and reenrollment applications and more. The public website does not require the user to have a password.
This secure area of the website requires you to log in. The secure site gives provider specific information concerning claim processing, client eligibility verification, secure file uploads & downloads and other similar functions. You can also review your remittance advices and much more. For assistance or questions concerning how to log into the secure section of the web portal, please contact Gainwell Provider Relations at 800-842-8440.
Client Eligibility
Please note, it is important to verify client eligibility each time you see a HUSKY Health or Covered CT member. Just like commercial insurance, members may lose their eligibility for a number of reasons. It is important to retain the record number when you obtain the member’s eligibility status, as in very rare instances, the eligibility record may be inaccurate. This number will allow you to prove that you verified the member eligibility on the date of service and will allow you to be reimbursed for any covered services you performed.
You can check member eligibility after logging on to the secure portal on the CT Dental Health Partnership website: https://ctdhp.org/dental-providers/provider-login/. Once you log in, click Client Inquiry to determine eligibility.
You can also check member eligibility status on CMAP:
- www.ctdssmap.com
- Choose “Information”
- Scroll down and select “Publications”
- Scroll down to Chapter 4, “Client Eligibility”
- Click “Chapter 4”
Lastly, you can check with the Automated Voice Response System (AVRS). The Automated Voice Response System (AVRS) is available 24 hours a day, seven days a week (except for maintenance) and allows self-service features for enrolled providers such as client eligibility verification, and access to client/program information through a touch tone telephone.
- The provider initiates the request by dialing 1-800-842-8440 (toll free).
- The system interacts in a series of verbal prompts and responses as the provider, client, and specific service date data are entered. The system responds to the provider requests in the form of a voice response.
