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Trauma Questionnaire Fax Number pdf

Connecticut Medicaid (HUSKY Health)·CT · Emergency Medicine, Critical Care, Orthopedics +2 more·Provider Bulletin
Effective date
Sep 17, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut hospitals can now fax trauma questionnaire forms and supporting documentation to DXC Technology at 1-833-577-3519 instead of only mailing them. The updated trauma questionnaire form will include this fax number starting October 2019.

Action Required

Action needed
Connecticut hospital providers: Update trauma questionnaire submission process to include new fax option (1-833-577-3519) alongside existing mail option (P.O. Box 2981 Hartford, CT 06104). Train staff on dual submission methods for trauma documentation to DXC Technology.