As a routine business practice, claims are subject to payment edits that are updated at regular intervals and generally based on CMS (including the National Correct Coding Initiative [NCCI] edits), specialty society guidelines and drug manufacturers’ package label inserts.
Provider Update is CarePartners of Connecticut’s quarterly newsletter for providers, hospital administrators and ancillary providers in the CarePartners of Connecticut network. Provider Update is CarePartners of Connecticut’s primary vehicle for providing 60-day notifications and other critical business-related information to providers.
CarePartners of Connecticut’s online self-service tools enable providers to submit transactions and/or access information related to claims submission, claims status, referrals, prior authorizations, electronic remittance advice, member eligibility, panel information, etc., electronically.
The Provider Resource Center is a central repository on CarePartners of Connecticut’s public Provider website where providers and office staff can find provider documentation including, but not limited to, the Provider Manual, payment policies, forms, and clinical and prior authorization criteria.