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At Colorado Access, caring for you and your success is our top priority as you serve our members. This monthly Provider Update highlights important information and resources to help you as a contracted provider with us.
Public Health Emergency (PHE) Update
The PHE is ending May 11, 2023. Health First Colorado (Colorado’s Medicaid program) and Child
Health Plan Plus (CHP+) members will return to normal eligibility renewal processes. Noticing began in March 2023 and renewals will start to be due this month. The redetermination process will take place over 12 months, so not all members will have to renew at the same time. Members will be due for renewal in the calendar month they enrolled.
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The State of Colorado's Provider Web Portal
The state of Colorado’s Provider Web Portal has moved here. Please make sure to update your bookmarks with the new URL.
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Quick Guide Updates
The provider web portal quick guide was updated to show the differences between coverage under the Family Planning (FAMPL) benefit and the Emergency Medical and Reproductive Health Program (EMS). Learn more here.
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Scam Alert
Health First Colorado and CHP+ members and applicants may be targeted by scam text messages and phone calls. Scammers may threaten members and applicants with loss of health coverage or legal action, demand money, or ask for sensitive personal information. The Colorado Department of Health Care Policy and Financing (HCPF) does not ask for money or sensitive personal
information like social security numbers over phone or text; HCPF also does not threaten legal action over phone or text.
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Telehealth Coverage Discontinued for Well Child VisitsTelehealth coverage for well child visits was added during the PHE, but as the PHE ends, this coverage ends on May 12, 2023. You will still be reimbursed for in-person well child visits. The affected procedure codes are: 99382, 99383, 99384, 99392, 99393 and 99394. Learn more here.
Read More >>2023 Health Equity Plan Public
Meetings
HCPF has multiple health equity plan public meetings coming up. These meetings are for providers, members, and community stakeholders to learn more about the plan and give input and feedback.
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On April 18, 2023, the U.S. Food and Drug Administration (FDA) amended the emergency use authorization (EUA) for the Pfizer-BioNTech and the Moderna bivalent COVID-19 vaccines to simplify the vaccination schedule for most people, including authorizing both vaccines to be used for all doses for anyone 6 months old or
older. This includes an additional dose or doses for certain populations.
Read More >>Statewide Utilization Management Standards for Behavioral Health Providers HCPF has been working with the Regional Accountable Entities (RAEs) to create statewide standardized utilization management (SSUM) guidelines to assess the most appropriate level of care for children referred for residential treatment. These guidelines complement national UM standards RAEs use to authorize behavioral health services. They have information about Qualified
Residential Treatment Programs (QRTP) and Psychiatric Residential Treatment Facilities (PRTF).
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For Obstetrics and Maternity Providers: Revised Obstetrical Global Billing Requirements
Read More >>Doc2Doc Well-Being Consulting The Colorado Medical Society has three free, confidential peer well-being consultation sessions available for any Colorado physician or medical student. Call their hotline 24 hours a day, seven days a week at 720-810-9131 to talk to a masters-level licensed clinician. Learn more here.
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For Opioid Treatment Providers: Take-Home Buprenorphine
As of May 1, 2023, a new policy is in
effect where opioid treatment providers (OTPs) may dispense up to a seven-day supply of take-home oral buprenorphine and buprenorphine combination physician-administered drugs (PADs) to Health First Colorado members. These PADs are to be billed through standard buy-and-bill processes when an OTP:
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Upcoming Provider Forum Please join us on Thursday, May 18, 2023 at 12:30 p.m. for our annual administrative payment model information session on Zoom. In this forum, we will review updates to our administrative payment model that will go live on Saturday, July 1, 2023.
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Dental Payment Update The technical specifications for HCPF’s dental key performance indicator
(KPI) have changed to require that oral evaluations be performed only by providers with dentistry-related taxonomy codes. This means that very few of the oral evaluation services done within the primary care medical provider (PCMP) network counted towards meeting the FY 2022-2023 Quarter 1 KPI goal.
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