Many dental practices and health care institutions were affected by the cyberattack on the ChangeHealth® systems, owned by UnitedHealth Group.  This cyber attack is being resolved and investigated but has interfered with claims submission to the payors – both commercial and governmental.  Gainwell Technologies (GT) was not affected by the cyberattack and has remained fully functional and able to adjudicate claims and continue with other functions such as eligibility verification, posting of claims, prior authorization and calculating the Adult Benefit Maximum (ABM) limits.  DSS and GT understand there is a significant problem with all provider types getting paid.  Additionally, the BeneCare systems, the administrator of the CTDHP have been down and have been slowly being brought back on line. As of March 12, 2024, the prior authorization portal is back and running, the Call Center can look up client related information and prior authorization history from the CTDHP call Center.

If you are having difficulty with your claims, there are two methods in which they should be addressed.  First, the GT Provider Web portal has been working and all claims can be submitted through your web portal. Go to www.ctdssmap.com and login using your usual credentials.  For difficulty logging into the secure Web portal, refer to the step-by-step provider instructions on accessing the secure web portal found on www.ctdssmap.com, go to “Information” on the menu bar, then select “publications”. Scroll down to the Provider Manual panel and click on the link under Chapter 10. Detailed instructions can be found in the manual. This will be the quickest method to obtain payment and all claims that you submit will be adjudicated in the next claims cycle which is in 14 days.

If your staff is unable to use the web portal, you can  request a “payout” from Gainwell Technologies.  A payout is when DSS advances money for the claims, and then as you submit new claims, the amount to pay for the claims is deducted until the payout money is paid back; this is known as “reconciliation”.  Note, this is against all claims submitted, not the ones that remain outstanding.  If you request a payout, please email: donna.balaski@ct.gov  with the following information>: Name of Billing provider, NPI of the billing provider, Tax ID , address amount being requested.  This is to keep track of who is in need of a payout.  You will also need to call Gainwell Technologies at 800 – 842 -8440 and request the payout with a specific amount that you are requesting.

The next step your office will need to take is to ensure that your new claims vendor (many people are using Dentrix®) or other claims clearinghouse is connected to Gainwell’s systems to resume your normal process of billing.  To date, this is the greatest reason that people are unable to use their new clearinghouses. Gainwell can assist with the requirements and technology related components of this process.

UnitedHealth Group has recently stated that key claims and payments services won’t be fully restored until March 22. HHS recently released a full letter to all Health Insurance leaders addressing the situation.

Please contact CSDA if you are experiencing difficulties after following the steps outlined above.