Navigator - Provider Newsletter from Colorado Access

We share in your concerns about COVID-19 and how it is currently affecting

operations. At this time, please know that Colorado Access remains fully operational. Our business continuity plans are in effect, and all core functions are being handled remotely whenever possible. Our customer service, provider relations, and care management teams are all available to assist as they normally do. On-site visits have been canceled, but we are available. Essential meetings are being conducted virtually.

Please also note the following:

Claims payments are being processed normally. We do not anticipate any disruptions in our ability to pay provider claims.

We are staying up-to-date with guidance from the Department of Health Care Policy and Financing (HCPF). Current information for providers can be found on their website. We anticipate that HCPF will release additional guidance for providers and RAEs over the coming days and weeks. 
HCPF is actively working with the Centers for Medicaid and Medicare Services (CMS) to address Medicaid reimbursement for telephonic services. Further information about telephonic visits and telemedicine and how we are addressing it can be found here.

It is critically important that we focus on supporting our members during this time by providing the best care through whatever means are available. Documenting what’s being provided will support future resolution of regulatory and payment issues, and we thank you for your support to continue to provide care to the members we all serve.

If you have any specific questions, please contact your provider relations representative directly, or send an email to ProviderRelations@coaccess.com. If you have general questions about COVID-19 as it relates to Colorado Access, please submit them here. Please continue to check our website at coaccess.com/covid19 for answers to the most frequently asked questions.

The Metro Denver Partnership for Health (MDPH) is a collective of six local public health agencies serving the seven-county Denver metropolitan area, that includes Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas and Jefferson counties. MDPH has put together some resources and recommendations to help you in your testing efforts and want to ask for your help to understand the testing capacity in the front range:

A health system testing guidance document has been created for your reference. Public health leaders are urging you to begin prioritizing and testing all symptomatic patients. How to screen, assess and schedule these patients for appointments is outlined in the attached document. These procedures do not replace any processes you already have in place; however, if you want to increase your services and are considering who you want to test, please use this document to support your work.

Collaboration with CDPHE and 2-1-1 is being considered to develop a repository for patients to find testing sites. In the coming weeks you will receive a testing capacity survey to complete. The goal is to help both the state and local leaders understand health systems’ COVID-19 screening, specimen collection, or testing efforts in one place. It will be used to help quantify testing capacity in each community and connect patients to care.

We understand barriers you may be facing with increasing your testing efforts, including having sufficient number of supplies and personnel. We are here to help support your efforts and connect you with the appropriate resources. If you have any questions, please contact Nicole Steffens from the Colorado Health Institute at steffensn@coloradohealthinstitute.org.

The goal is to ensure that we understand the breadth of COVID-19 in our community and improve our containment efforts through increased testing. Ensuring that we all have the same information will help patients and community members clearly understand how they can receive support.

Do you have patients who need help to enroll in Medicaid or other state health care services? The Colorado Access MA Site is a state certified medical application assistance site for Health First Colorado (Colorado’s Medicaid Program), Child Health Plan Plus (CHP+), or long-term care coverage. They accept and process applications just like the Department of Human Services in Colorado.

The Colorado Access MA Site office is currently closed to the public and all in-person interviews, but they can still help. Application processors are ready to guide applicants through the application by phone. They also accept applications by mail, email or secure drop box at the office to drop off an application. You can contact them by phone at 303-755-4138 or 855-221-4138 (toll free). Their fax number is 720-744-5227, and email address is appassist@accessenrollment.org. You can also visit them online at accessenrollment.org. If you have questions, please contact Deb Fitzsimmons at debra.fitzsimmons@coaccess.com or 720-744-5269.

In response to the COVID-19 outbreak, we have developed a digital engagement program that targets all RAE (Region 3, Region 5), CHP+ HMO, and CHP+ SMCN members to provide information and resources about the outbreak. The program includes eight text messages with online resources for our COVID-19 webpage, the CDPHE COVID-19 webpage, and our care management phone number. The text messages also direct members to talk to their primary care provider if they have COVID-19 symptoms, are experiencing extreme anxiety, need help getting prescriptions, and to determine if telehealth options are available. The end date of this program has yet to be determined as we continue to monitor the effects of the COVID-19 outbreak.

Behavioral Health Documentation Quality Standards and Review

As we mentioned last month, our quality team regularly monitors provider documentation to ensure that all participating providers who deliver behavioral health services meet quality documentation standards.

Did you know:
The top two measures that providers most commonly meet are:

Assessment: Date of Service is documented
General Documentation: Chart is legible

The top five measures that providers most commonly miss are:

Assessment: Mode of treatment is present
Assessment: Barriers to treatment are present
Assessment: Place of service is present
Treatment: Goals are measurable
Treatment Plan: Treatment plan is strength based

How can you improve your own chart documentation?

Review the “Quality Improvement Behavioral Health Documentation Training” found on our Provider Training page.
Conduct a peer or self-audit a few of your behavioral health charts to ensure your documentation meets standards.

If you have any questions, please contact your provider relations representative directly, or send an email to ProviderRelations@coaccess.com.

Copays Waived

We have now waived the copay for CHP+ HMO and CHP+ SMCN inpatient claims with a confirmed COVID-19 diagnosis. This is effective April 1, 2020.

This is in addition to the previously waived copays for testing of the COVID-19 virus. As previously communicated: we are waiving copays for testing of the COVID-19 virus for CHP+ HMO and CHP+ SMCN members. CMS has issued new Healthcare Common Procedure Coding System (HCPCS) codes that can be used to bill certain COVID-19 diagnostic tests to help increase testing and track new cases.U0001 (CDC 2019 Novel Coronavirus (2019-nCoV) real-Time PCR Diagnostic Panel) and U0002 (2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types for Subtypes (includes all targets(, non CDC) are available for providers to bill without a prior authorization or a copay to the member.

If you have any questions, please contact your provider relations representative directly, or send an email to ProviderRelations@coaccess.com.

Sandy Rangel has worked in health care for eight years, three of which have been at Colorado Access. She is originally from Mexico City but loves living in the Denver area, especially when cheering on her Broncos! As an internal provider relations representative, Sandy is always there for any needs providers may have.

Outside of work, Sandy loves spend time with her dog, a furry schnauzer. She also loves to hike and travel the world. Her favorite quote, by Gustav Flabert, sums up her love for travel: “Travel makes one modest. You see what a tiny place you occupy in the world.”

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