Prior Authorization in Connecticut
Soft Home Global provides authorizations submitted ahead of the date of service and chased to a decision for Connecticut practices and billing companies at $1,900 per seat per month. Full time, worked during Connecticut business hours, inside your own system.
What is specific to Connecticut
Connecticut moved HUSKY Health off risk-bearing managed care in 2012 and now self-insures the program, paying claims fee-for-service through administrative services organizations rather than through contracted managed care plans.
Connecticut’s Medicaid program is HUSKY Health. Practices with a meaningful HUSKY Health mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
Medicare here is adjudicated by National Government Services, jurisdiction JK — shared with Massachusetts, New York and Rhode Island. CMS publishes the jurisdictions; checked September 2026.
What a prior authorization seat does in Connecticut
Submitted before the date of service and chased through the payer's decision window.
An authorisation found after the visit is a write-off, not a denial to appeal. In Connecticut the work is submitting ahead of scheduling and chasing the decision, against a payment clock that starts only once a clean claim lands.
- Authorizations submitted ahead of scheduling, not after
- Status chased rather than waited on
- Peer-to-peer reviews scheduled when required
- Clinical documentation gathered before submission
- Expiring authorizations flagged before they lapse
- Worked during Connecticut business hours, not queued overnight
For the statute behind all of this — Connecticut’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Connecticut billing page.
HUSKY Health, in practice
HUSKY Health (Medicaid and CHIP) is run by the Department of Social Services through a single medical Administrative Services Organization rather than competing risk-bearing MCOs, so providers deal with one medical administrator statewide. Quotes: "HUSKY Health includes Medicaid and the Children's Health Insurance Program, and is administered by the Connecticut Department of Social Services (DSS)."; "the State of Connecticut's Medical Administrative Services Organization (ASO) for the HUSKY Health program". Source: huskyhealthct.org
HUSKY dental is carved out to a separate administrator, so dental claims do not route through the medical ASO. Quote: "The Connecticut Dental Health Partnership (CTDHP) is part of the HUSKY Health program. Specifically, the CTDHP provides management and customer service for the dental benefits portion of HUSKY Health." Source: portal.ct.gov
For authorisations it decides who you ask. A carve-out means the rules, the portal and the turnaround belong to a different administrator from the one handling the rest of the member’s care, and an authorisation obtained from the wrong one is not an authorisation.
Working Connecticut hours
Connecticut runs on Eastern time, 10 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 7pm to 3am, and 6pm to 2am once the clocks go forward. Pakistan does not observe daylight saving, so the shift moves on this side rather than yours.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on Connecticut hours and nobody else’s.
What it costs in Connecticut
$1,900
Per seat, per month, in US dollars — $22,800 a year for one full-time person, forty hours a week, on Connecticut hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Connecticut run $1,500 to $2,500; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in Connecticut
About a week from a signed agreement to a person working your queue, and that week of training is not billed on top. The week, step by step, and what is signed before anyone has access.
If working with staff outside the United States is new to your practice, see how a medical billing company structures that seat and why offshore medical billing does not have to mean losing visibility into the work.
Questions
Do you work with Connecticut practices?
Yes. Connecticut accounts are worked during Connecticut office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Connecticut?
Connecticut moved HUSKY Health off risk-bearing managed care in 2012 and now self-insures the program, paying claims fee-for-service through administrative services organizations rather than through contracted managed care plans.
Which Medicare Administrative Contractor covers Connecticut?
National Government Services, the A/B MAC for jurisdiction JK. Medicare Advantage and commercial plans run their own authorizations; for traditional Medicare, the hospital outpatient services on CMS’s prior authorization list are reviewed by this MAC.
When does a Connecticut payer have to pay a clean claim?
20 days for claims submitted electronically; 60 days for paper claims The authorization gets the service approved; this is the deadline for paying the claim that follows it, once that claim is clean.
How fast must HUSKY Health decide a prior authorization?
Under the federal CMS-0057-F rule, from 1 January 2026: 72 hours for an expedited request and seven calendar days for a standard one, for Medicaid fee-for-service and Medicaid managed care plans alike, counted in calendar time whether the request went by portal, fax or phone. The calculator at softhomeglobal.com/prior-auth-deadline works out the date.
How much does prior authorization cost in Connecticut?
$1,900 per seat per month — $22,800 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our Connecticut queue?
Connecticut is on Eastern time, 10 hours behind Rawalpindi. The shift here runs 7pm to 3am so your seat is at a desk for your full working day, shifting to 6pm to 2am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle HUSKY Health as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. HUSKY Health has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
More for Connecticut
Next step
One seat on your Connecticut work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com