Navigator - Provider Newsletter from Colorado Access

Dear Health Community Colleague,

Welcome to the March Navigator. In this issue, you’ll find information about how to support Ukraine relief efforts, an upcoming Colorado Access provider forum, our new claims and payment system that is coming soon, moving from pandemic to endemic, POS 10 service coding, an opioid crisis public feedback opportunity and more.

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

There is a new place of service code 10 (Telehealth Provided in Patient’s Home) and an updated description for place of service code 02 (Telehealth Provided Other than in Patient’s Home). Providers can begin billing place of service 10 when applicable. Please note: for bills you submit to Colorado Access, we are allowing POS 10 to start January 1, 2022, but it is not required until April 1, 2022.

Click here for more information.

In March 2022, a new multi-step renewal process for all Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+) members will be implemented. The Colorado Department of Health Care Policy and Financing (HCPF) is hosting three learning sessions to share information with community partners about this “Renewal Revamp” project. The sessions are scheduled for Tuesday, February 15th; Thursday, February 17th; and Tuesday, February 22nd. Click here to learn more.

We are excited to announce that we are implementing a new system that will make claims and payment processing even more efficient. What this means for you: you will be introduced to a new provider payment portal. Over the next few months, before we go live on July 1st, we’ll share some more information and the benefits of it. As we move toward implementation, your provider network specialist will be available to answer questions. If you do not have a provider network specialist, please email the team at providernetworkservices@coaccess.com.

We are partnering with DentaQuest on a few programs that may be of interest to your patients:

The Smiling Stork Program is designed to educate pregnant people and health care providers on the importance of being screened and treated for oral disease, safety of dental care during pregnancy, and the value of establishing good oral health habits for babies. Please encourage your patients to schedule dental checkups during pregnancy. Find more information here.
The Healthy Beginnings Program provides oral health education, encourages caregivers to be proactive in their child’s dental care and helps caregivers to establish a dental home. To achieve this, DentaQuest: 1. Works with dental providers to encourage early preventive dental visits. 2. Outreaches to caregivers with young children to provide age-appropriate oral health education and assist in identifying a dental home provider. Find more information here.

If you have questions about either program, please contact Sarony Young, DentaQuest member outreach coordinator at sarony.young@dentaquest.com.

Governor Jared Polis and state health officials announced the shift from the COVID-19 pandemic to an endemic response deemed “Colorado’s Next Chapter: Our Roadmap to Moving Forward.” The plan is to take a phased approach that includes planning for the next variant and addressing the health care worker shortage and related issues.
The phases for the shift from pandemic to endemic are:

Establishing hospital readiness standards, surge planning and normalizing COVID-19 patient care in traditional medical settings.
Ensuring public health readiness and surge capacity.
Investing in health care workforce stabilization and expansion.
Engaging the federal government in national endemic response, pandemic readiness and needed reforms.

Read more from the governor here.

We invite you to attend our PCMP Provider Forum focused on the new Administrative Payment Models that go live on July 1, 2022. This forum will take place on Tuesday, May 17, 2022 at 12:00 p.m.

The PCMP Provider Forum will review the new metrics included in the model, along with how per-member-per-month payments are determined. Additional time will be available for provider questions.

If your site is designated as a PCMP+, please attend this forum as well as an additional meeting to review your enhanced per-member-per-month payment. If your site is designated as an ECP, you should attend a different provider forum on Thursday, May 19, 2022 at 12:00 p.m.

Starting July 1, 2022, these gender identity disorders will only be reimbursed under the Capitated Behavioral Health Program:

F64.0 Transsexualism
F64.1 Dual role transvestism
F64.2 Gender identity disorder of childhood
F64.8 Other gender identity disorders
F64.9 Gender identity disorder, unspecified

As a Health First Colorado provider, you will no longer be able to bill the Outpatient Behavioral Health fee-for-services benefit for services provided for one of the diagnoses listed above, when a member is enrolled in the ACC and is assigned to a RAE. If you wish to bill for behavioral health service provided for gender identity disorders, you must contract directly with the RAE(s). Find more information here. If you have any questions, please contact Sandy Grossman at sandra.grossman@state.co.us

These webinars provide opportunities to advance equitable care and outcomes at the point of care through individual, community, and system change:

Words Matter: How Language Used in Health Care Settings Can Impact the Quality of Pediatric Care – Examines the impacts of conscious and unconscious provider bias, particularly through written and spoken communication, and how care rooted in mutual respect can empower patients and families. Learn more here.
Using Health System and Provider Culture Change to Address the Impact of Racism and Bias on Patient Outcomes – Explores anti-racist and trauma-informed approaches aimed at influencing health system and provider culture to address racial health disparities. Learn more here.

Our Text4Baby program is an SMS (text message) wellness program for pregnant Health First Colorado and CHP+ members who are 18 and older. Text4Baby provides educational messages timed to gestational age or birth age, as well as interactive surveys, modules and reminders to improve maternal and child health outcomes, for pregnant and new mothers and their partners with babies up to age 1, as well as providers. Surveys and modules help assess prenatal, postpartum, and well-baby visit attendance, as well as prenatal risk assessments or missed childhood vaccines.

“Starter pack” messages begin on the first Monday after a pregnant member is enrolled. “Pregnancy protocol” messages begin after the completion of the “starter pack” for members who enroll as pregnant and give their baby’s due date. Messages are sent on Mondays, Wednesdays, and Fridays and are timed around the baby’s due date. They encourage members to get more information on a topic by clicking on URLs in the message.

“New baby” messages begin after the member’s due date has passed, or on the first Monday, Wednesday, or Friday after enrollment. These messages will last until the baby turns one year old, and cover topics such as vaccinations, well visits, and appointment reminders for both mother and baby.

If you have any questions about this program, please email populationhealth@coaccess.com.

The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control is updating the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. The updated draft Clinical Practice Guideline for Prescribing Opioids is available for public comment. The public comment period will be open for 60 days, through Monday April 11, 2022. All patients, caregivers, providers, and others who care about safe, effective, and informed pain treatment options are encouraged to submit their comments through the Federal Register docket. Find more information here.