CT Medicaid News: Third Party Audit Letters and Reports to be Electronically Delivered

As of June 1, 2025, Third Party Liability (TPL) Audit Letters and Reports will begin electronic delivery to providers who have established Secure Web portal accounts. Providers who have yet to establish their Secure Web portal accounts, will continue to receive these letters via USPS mailings.

To simplify claim submission, Gainwell Technologies (CT Medicaid), will not require electronic claims attachments for claims that have other insurance payment, other insurance denial, or Medicare denial. While attachments are not sent to Gainwell Technologies, providers are still required to retain these attachments for post payment audits. Failure to respond to the audit results in recoupment of the claims listed on the audit report.

1. Providers will receive an email notifying them when a new letter(s) has been posted to their Secure Web portal account. This email notification will be sent to the email address associated to that Secure Web portal account.
2. Providers will need to log into their Secure Web portal account and follow the guidance below to download the TPL Audit letter(s)

Resources:

• Implementation of Electronic Delivery of Letters
• Provider Bulletin 2025-21

Source: ctdssmap.com