Navigator - Provider Newsletter from Colorado Access

Dear Health Community Colleague,

In this issue, you’ll find important information about the Child Health Plan Plus (CHP+) State Managed Care Network, provider revalidation, the Colorado Access member survey, and transportation information for COVID-19 vaccines.

Be on the lookout later this month for the second issue of the May Navigator, where we’ll continue our deeper dive into social determinants of health, offer more COVID-19 resources, and highlight another provider partnership in the community.

If you want to learn more about anything in this issue of the Navigator or just have a question, please contact us. You can also connect with us on any of our social media channels using the links below.

In good health,
Colorado Access

Effective July 1, 2021, all Child Health Plan Plus (CHP+) eligible members will be automatically enrolled into a CHP+ Managed Care Organization (MCO). As a result, if you do not have an active contract with a CHP+ MCO, you will not be eligible for reimbursement for services delivered to CHP+ members after June 30, 2021.

The CHP+ State Managed Care Network (SMCN) will no longer be available to pay for health care services delivered to CHP+ members after June 30, 2021. Begin the contracting process with CHP+ MCO(s) now to ensure continuity of care for members and timely reimbursement.

We will continue to participate in the CHP+ program as an MCO. If you are an SMCN provider, we encourage you to contract with CHP+ provided by Colorado Access for continued participation in the CHP+ program. If you are not currently contracted with an MCO, you should contact other participating CHP+ MCOs to begin the contracting process to be eligible for reimbursement for providing health care services to CHP+ members beginning July 1, 2021.

Please see the attached letter for more information. If you have any questions, please contact our provider relations team at providerrelations@coaccess.com.

Continue to submit provider revalidation applications to the Department of Health Care Policy and Financing (HCPF) according to your scheduled due date if you are able. However, until further notice, claims will not be denied or suspended if revalidation has not been completed by the posted revalidation due date.

Applications for new enrollments and changes to existing applications have been given priority. Revalidation application processing times may be delayed for the next several months. Only one update can be processed at a time. If you need to make an additional update while a revalidation application is in process, contact the Provider Services Call Center here.

We administered a member satisfaction survey in June 2020 and again in January 2021. The survey solicits feedback from those with Health First Colorado (Colorado’s Medicaid Program) to ensure they receive excellent customer service. It provides a valuable opportunity to hear from members and understand their experience. The responses from the survey will improve how we interact with and advocate for members.

The first member satisfaction survey compared office (in-person) and telehealth visits in three areas:

Quality of Care: Over 96% had Excellent or Good quality of care.
Satisfaction of Care: 95% were Extremely Satisfied or Satisfied with their care.
Timeliness of Appointment: About 80% said their appointments were Always or Usually timely for routine or urgent care.

The second, ongoing, member satisfaction survey ask members about their experiences with:

Respect by provider
Cultural and language sensitivity by provider
Understandability of provider
Achieving their health goals with the support of their provider

What can you improve? Region 3 and CHP+ and SMCN have the highest rates of “Never” having timely appointments for both telehealth and office visits. Access to care is imperative for promoting and maintaining health, preventing, and managing disease, reducing unnecessary emergency room visits and achieving health equity for our members. Visit the Quality section of our website for timeliness standards. Please ensure timely access for all of our members.

The past year has further exposed health disparities and social injustice faced by our most vulnerable populations. COVID-19 vaccine hesitancy is highest among the very populations most disproportionally affected by the pandemic. This includes communities of color as well as groups who are economically and socially disadvantaged. Perceptions and concerns regarding patients’ responses to getting the vaccine may discourage engagement in conversations that are essential to increasing vaccination rates. Outside of patients’ values, fears, and social norms, they have valid concerns and real barriers to getting the vaccine. Read more here.

Two new security features have been implemented: multi-factor authentication and a mandatory password reset every 90 days. With multi-factor authentication, the portal requires a second form of authentication to verify your identity. This can either be by email, text message or authenticator application. The portal also requires your password to be reset after 90 days. Please note: If you have not logged into the portal for six months, your account will be deleted. Access the portal here.

Community Events

Invitation to Apply for Funding Summer/Fall 2021: Youth Engagement Pop-Up Event Series
The Youth Violence Prevention Program is a newly funded initiative to implement a public health approach and intervention level efforts that are based on national models and best practices to prevent and address the youth violence crisis occurring in the City of Aurora. Both intervention and prevention level strategies will be implemented through a multi-disciplinary approach to include community-based efforts such as youth engagement pop-up events to increase neighborhood protective factors. The grant period is from June 20,2021 to October 31, 2021. Learn more here.

Colorado Families With School-Aged Students to Again Receive Pandemic-EBT Food Benefits
Coloradans with eligible school-enrolled children will begin to receive food benefits through the Pandemic Electronic Benefit Transfer (P-EBT) program starting in late May. This effort will help support Colorado's families during the COVID-19 pandemic.

The P-EBT program reimburses households for meals missed during school closures or reduced hours for students who are eligible for free and reduced-price school meals and attend a school that participates in the national school lunch program. This is a continuation of the P-EBT program that began in July 2020 to reimburse families on free and reduced-price lunch for meals missed at school due to COVID-19. Qualifying families will receive a cash-like benefit for August through May of the 2020-2021 school year for food-eligible purchases. Click here for more information.

The City of Aurora has created a new economic development program to connect people in the community who are experiencing food insecurity with free meals at local restaurants. If you work with people or groups that could benefit from this program, please contact Frank for more information at 303-739-7272 or email fbutz@auroragov.org.

If you have an upcoming community event that you'd like us to share, please email us.

Federal funding may now be used to purchase rapid fentanyl test strips (FTS). This is in an effort to help curb the dramatic spike in drug overdose deaths driven by the use of strong synthetic opioids, including illicitly manufactured fentanyl. FTS can be used to determine if drugs have been mixed or cut with fentanyl. This provides important information about fentanyl to people who use drugs and communities so they can take steps to reduce their risk of overdose. Click here for more information.

As of February 20, 2021, CHP+ Managed Care Organizations (MCOs) may reimburse network providers for the provision of well-child visits delivered through telehealth for children 2 years old up to 18 years old. Children 2 years old and older should receive a well visit in person whenever possible. When appropriate, providers may perform well visits using telehealth modalities. Any member that receives a well visit through telehealth should have a timely in-person follow-up visit to deliver necessary care that is incompatible with a virtual visit.

Billing Guidance:
You may bill procedure codes 99382, 99383, 99384, 99392, 99393, and 99394 rendered through telemedicine for children 2 years old up to 18 years old.

Federally Qualified Health Center (FQHC)/Rural Health Center (RHC)/Indian Health Services (IHS) Provider Billing Instructions for Professional Claims

Place of Service 02 must be indicated on all professional claims for well visits delivered by telemedicine.
You should complete the physical examination the next time the member is seen in person. If you perform a physical examination within four months of the telemedicine well visit, you should void the previously paid telemedicine claim and resubmit for payment of the well visit using the date of service of the physical examination.

FQHC, RHC, and IHS Provider Instructions for Institutional Claims

FQHC/RHC and IHS/Tribal 638 providers must indicate the well visit provided through telemedicine by appending modifier GT to the UB-04 institutional claim form line item with the service’s procedure codes.
FQHC/RHCs and IHS/Tribal 638 providers do not need to void a previous encounter when a physical examination is performed within four months of the telemedicine well visit due to their encounter payment methodologies.
Outpatient hospitals may not bill facility claims for telemedicine well visits.
You should perform in person well visits for children under age 2 or for children who need a vaccine or to arrange for vaccine administration in person following the telemedicine visit.