Dear Health Community Colleague,

Welcome to the new edition of the Navigator monthly newsletter. In this month's edition of the Navigator you'll find articles on NEMT changes, Colorado Access provider data, provider relations spotlight and more.

If you want to learn more about any of the articles in this issue of the Navigator, don't hesitate to contact us.

Thank you,
Colorado Access

Provider Meeting and gift card winner

Thanks to all who attended our provider meeting on Thursday, September 19th. And thank you to all who filled out a meeting survey.

After each meeting, we draw a name from those who filled out a survey and award a prize. This quarter’s winner of a $50.00 gift card goes to;

Cassie Krajewsk
Heart-Centered Counseling


We Now Offer Free Access with Virtual
Behavioral Health Services to its Network Providers
Our Virtual Care Collaboration and Integration (VCCI) Program supports primary care providers with managing behavioral health in the patient-centered medical home. VCCI allows PCPs to consult directly with psychiatrists and behavioral health clinicians, and also advances integrated care by providing direct behavioral health care to patients through telehealth in the primary care setting. Our telehealth team works with each individual practice to develop customized workflows that support the delivery of VCCI services.
The VCCI Program can be used for:

  • Psychiatric evaluations
  • Diagnostic assessments
  • Support with medication management
  • Short-term counseling
  • Collaborative consultations
  • Supporting behavioral health for pregnant and postpartum women.  Please see this press release for more information.    
  • Medicated Assisted Treatment (MAT) support. These services assist primary care practices in using MAT with patients who suffer from opioid use disorder (OUD). VCCI MAT provides:
  • Specialized MAT guidance and expertise for managing opioid addiction
  • Training and education around MAT prescribing and initiating addiction treatment
  • Ongoing consultation and support for MAT prescribing, specific case diagnosis, and assessment    
  • Brief virtual addiction case management and therapy  

Upcoming Trainings

Thursday, October 3, 2019

11:00 a.m. – Website Overview Training/Provider Portal Training/Provider Updates
12:00 p.m. – Physical Health Company Overview
1:00 p.m. – Behavioral Health Documentation Training
2:00 p.m. – Orientation for Primary Care Medical Providers

Thursday, November 7, 2019
11:00 a.m. – Website Overview Training/Provider Portal Training/Provider Updates
12:00 p.m. – Physical Health Company Overview
1:00 p.m. – Behavioral Health Documentation Training
2:00 p.m. – Orientation for Primary Care Medical Providers

Thursday, December 5, 2019
11:00 a.m. – Website Overview Training/Provider Portal Training/Provider Updates
12:00 p.m. – Physical Health Company Overview
1:00 p.m. – Behavioral Health Documentation Training
2:00 p.m. – Orientation for Primary Care Medical Providers

NEMT Administrative Changes

New Non-Emergent Medical Transportation (NEMT) Broker began September 1!

Starting in September, IntelliRide became the new broker for Health First Colorado’s NEMT benefit. To schedule new trips, or confirm existing trips for after 9/1/2019, call IntelliRide at 855-489-4999 or schedule online at

There is a short section on the HCPF website covering the change and linking to additional resources, here.  
Regional Program Improvement Advisory Committee (PIAC)

As a regional organization for the Health First Colorado (Colorado’s Medicaid Program) program, we operate two regionally-focused Program Improvement Advisory Committees or PIACs for Region 3 (Adams, Arapahoe, Douglas and Elbert counties) and for Region 5 (City and County of Denver). The purpose of these committees is to engage a broad range of local stakeholders—including Colorado Access members and families—in high-level strategy within the topics of physical and behavioral health. These committees provide guidance and make recommendations to Colorado Access on how to improve health, access, cost, and member and provider satisfaction within the regions we serve. If you know of anyone who would like to be part of this, click here for more information and find out how to get involved.

These meetings are open to the public. We are happy to provide reasonable accommodations for the meetings upon request for persons with disabilities as well as language accommodations. Please contact Nancy Viera at or 720-744-5246 at least one week prior to the scheduled meeting if you need accommodations.

Region 3

Colorado Access
11100 E Bethany Drive
Wednesday, December 11, 2019, 4:00-6:00PM via zoom

Region 5

Joseph’s Hospital Russell Pavilion
1375 E 19th Ave
Denver, CO 80218
Monday, December 2, 2019, 4:00-6:00PM via zoom

New Provider Data Available on the Colorado Access Portal

We are committed to providing you with useful data to help you in the care of your patients. We will now be posting practice-specific reports on member ED utilization, well visits, and dental visits. These reports will be located in the reports section of the provider portal, where the PEPR attribution report is currently located. If you have questions regarding the reports or need additional training on the provider portal, please contact your provider relations representative. You can email or call 844-430-6684.

DRG and EAPG Facilities Updates

DRG and EAPG rates are set by HCPF. HCPF publishes the rates with an effective date before they have been finalized by CMS. We will implement the new rates as soon as they are published by HCPF, on the announced effective date, even if they have not been approved by CMS. CMS occasionally rejects the rates. If and when this occurs, we will then reprocess any claims using any rate not approved by CMS.  This process is intended to result in fewer claims adjustments and an earlier implementation of rate changes.

Our quality department monitors to ensure all participating providers who deliver behavioral health services meet quality documentation standards. They have developed a comprehensive training on our most up-to-date behavioral health documentation standards for assessment, treatment planning, progress notes, and case management documentation. Quality audit criteria is based on regulations, billing manuals, industry best practices, and other sources that support quality documentation and help identify areas of training and education. This training is titled "Behavioral Health Documentation Training" and can be found on the Colorado Access Provider Training page located at here.

You may receive requests for documentation records to be audited by the quality department for review. Audit tools have been built using standardized measures and scoring practices and tailored to the quality audit criteria. These quality audit tools have been tested with inter-rater reliability and calibration activities to ensure consistency in scoring. Following completion of quality audits, we will provide a summary report of findings. If necessary, these findings can include a corrective action plan to promote documentation that will enable the provider to more fully comply with quality documentation standards. Please also see the provider manual for specific quality audit measures.

Pediatric Asthma Digital Engagement Program

We have developed a new digital engagement program that targets parents/guardians of both RAE and CHP+ HMO members ages 0-18. By using a multi-channel approach (interactive voice response call and text), the program focuses on informing members about tools and resources they can use to better control their child’s asthma symptoms. The program aims to motivate families to determine an asthma action plan with their primary care providers with the goal of reducing emergency room visits due to asthma complications while improving asthma management among the pediatric population.

This is an ongoing program where the parents/guardians of members who fit the program criteria will receive multiple calls or texts with this information. Additional parents/guardians are integrated to the program monthly. For more information, please email Kara English, senior health programs specialist, at
Though Denver native Elina Navarro has worked at Colorado Access for just three years, she actually brings 15 years of health care experience to her role.

Driven by the goals and values of Colorado Access, she enjoys being a provider relations representative because she can build strong relationships with providers and remove barriers to member care.

Her mother, husband, and daughter inspire her to make the world a better place and guide all her actions within her home and out in the world with love. Outside of work, Elina loves to read, garden, and spend time with her family. She also loves to spend time in the mountains.

Elina is crafty by nature and enjoys making soap, dry herbs, spices and lotion. But it doesn’t stop there! She is also an excellent cook.

11100 E. Bethany Dr.
Aurora, CO 80014

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