Providers who want to order services that are not covered under ConnectiCare Medicare Advantage plans should follow a process known as "organization determination."
To obtain an organization determination from ConnectiCare, providers can:
ATTN: Medicare Utilization
P.O. Box 4050
Farmington, CT 06034-4050
If we deny a provider's organization determination request, we will issue an integrated denial notice (IDN) to both provider and member. The IDN will include information on how to appeal.
ConnectiCare will not pay for – and the provider cannot bill the member for – any non-covered service if the organization determination process isn't followed.
If ConnectiCare issues an IDN, however, the provider may hold the member responsible for the cost of a service.
For more information, or answers to your questions, please contact Medicare provider services at 1-877-224-8230.