Providers News and Updates

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In response to the reimbursement interruption and impact caused by the Change Healthcare Cyberattack incident and in accordance with federal Medicaid guidance from the U.S. Centers for Medicare and Medicaid Services, the Department of Social Services (DSS) will be accepting interim payment requests from affected providers in order to maintain a continuation of care to members without interruption.

Read More Here.

 

Cybersecurity expert Gary Salman offers insight on what causes data breaches and how they relate to dental practitioners, including obvious signs a cybersecurity incident has occurred and practical ways dental offices can prevent data breaches from happening. “Many practices still harbor a broken mindset, meaning they believe they are immune to breaches, thinking that it won’t happen to them,” he said.  Read the ADA Article Here.

Noninferiority of Silver Diamine Fluoride vs Sealants for Reducing Dental Caries Prevalence and Incidence A Randomized Clinical Trial

Ryan Richard Ruff, PhD, MPH; Tamarinda J. Barry Godín, DDS; Richard Niederman, DMD

Dental caries is the world’s most prevalent noncommunicable disease and a source of health inequity; school dental sealant programs are a common preventive measure.
Silver diamine fluoride (SDF) may provide an alternative therapy to prevent and control caries if shown to be noninferior to sealant treatment.  Read more here.

All Gainwell Provider Updates here.  The most recent update was issued on 2/29/24.

Emergency Prior Authorizations may be called into the Provider Services Prior Authorization line at 888-445-6665.

For claims payment related issues, please call the Gainwell Helpline at 800-842-8440.

New! Temporary Process to Receive Client Eligibility Status, Claims History and Adult Benefit Maximum Data from CTDHP: Providers can contact the Member Service Center to receive Patient information on 5 or fewer patients per call. Please call 855-283-3682. And, have the following information ready for CTDHP: Client Name, Medicaid ID, Date of Birth, Provider NPI.

Providers can also complete this form and fax to CTDHP at 860-674-8174 to receive information for 6 or more patients. You can provide multiple copies of the form.

CTDHP will return via fax the completed information. Faxes will be processed in the order received and completed within 4 hours of when the fax was received. Any faxes sent to CTDHP after 4pm will be processed and sent the next business day.

Prior Authorization and Post Procedure review can be submitted via standard mail. The J434 Standard ADA Claim Form and all required supporting documentation may be sent to CTDHP/BeneCare at:

CT Medicaid Prior Authorization

C/O Dental Benefit Management/BeneCare
555 City Ave East Suite 600
Bala Cynwyd, PA 19004
Orthodontic Prior Authorization requests can be sent to:

Orthodontic Case Review
C/O BeneCare Dental Plan
195 Scott Swamp Road, Suite 101
Farmington, CT 06032

Please note, decisions regarding the Prior Authorization requests are provided within fifteen business days of receipt.