Traditional MedicareAdministrativeHigh impact
DSS Important Message - EVV Updates regarding TPL Billing for Dually Eligible Clients – 02.06.2025
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Feb 6, 2025
We identified it
Jun 20, 2026
Summary
Home health providers billing for dually eligible clients (Medicare and Medicaid) must update their Santrax system entry procedures and billing workflows. Key changes include entering Client Medicaid ID in two specific fields, removing Medicare as payor for dually eligible clients, and ensuring 48-hour confirmation wait periods to prevent claim denials.
Action Required
Immediately: Home health billing teams must update Santrax workflows for dually eligible clients: (1) Enter Client Medicaid ID in both 'Other ID' field under 'Agency Designations' on Personal screen AND 'Cust. No.' field on General screen, (2) Remove Medicare payor information - enter only Medicaid as payor, (3) Confirm all services then wait 48 hours before sending billing file to Gainwell Technologies, (4) Enter Medicare payor, correct adjustment reason codes (151, 152, or 153), and HHABN issuance date in vendor software prior to billing. Failure to follow these steps will result in claim denials with EOB codes 3332 or 3328.