Navigator - Provider Newsletter from Colorado Access

Dear Health Community Colleague,

Welcome to the first issue of the Navigator for April. In this issue, you’ll find important information about provider revalidation, Colorado’s COVID-19 Vaccine Equity Fund, and transportation information for COVID-19 vaccines.

Be on the lookout later this month for the second issue of the April 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

Please 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.

Effective March 15, 2021, HCPF is reimbursing physicians, federally qualified health centers, hospitals, pharmacies and other Medicaid-enrolled, qualified immunizers $41.18 to administer each dose of a COVID-19 vaccine. Pharmacists enrolled with Health First Colorado may submit claims for reimbursement of the administration of COVID-19 vaccines to Health First Colorado members. Providers will receive vaccine products from the federal government at no cost.

Only the administration fee associated with the vaccines may be reimbursed to providers. Find additional information here.

COVID-19 Vaccine Update
Join our practice support team and Heather Roth from Colorado Department of Public Health and Environment (CDPHE) on Friday, April 16th from 12:15 p.m. to 1:00 p.m. for an update on the COVID-19 vaccine deployment in Colorado. Register here. If you have questions, please email practice_support@coaccess.com.

Denver Children’s Advocacy Center
(DCAC) has free upcoming webinars for May, June, July and August on Trauma Informed Care: The Basics of the Brain. Find more information and sign up here.

Community Events

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.

Denver Food Rescue expanded their No Cost Grocery Program through new partnerships with Casa de Rosa in Villa Park and Bigger Than Me in Park Hill. Find more information about their programs, including where to find them, here.

Tortillas for Tepeyac Virtual Event: Save the date this event taking place on Thursday, May 6th at 6:30 p.m. If you would like to learn more about sponsorship opportunities, please contact Heather Orr at horr@tepeyachealth.org or 303-458-5302 ext. 2925. For more information, please contact us.

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

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.

Effective July 1, 2021, all members who are eligible for CHP+ 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 for CHP+ members delivered after June 30, 2021. Begin the contracting process with CHP+ MCO(s) now to ensure continuity of care for your patients and timely reimbursement.

Active contracts between CHP+ providers and participating CHP+ MCOs will not be affected by this transition.

Action Needed:

Colorado Access will continue to pay claims for the SMCN for dates of service through June 30, 2021. Colorado Access will stop processing and paying claims for the SMCN for dates of service beginning on July 1, 2021.
If you are contracted with SMCN, you should continue to see members through June 30, 2021.
If you are a contracted SMCN provider, you must submit all claims with dates of service through June 30, 2021 to Colorado Access for adjudication in accordance with timely filing requirements.
If you are not currently contracted with an MCO, you should contact CHP+ MCOs to begin the contracting process to be eligible for reimbursement for providing health care services to CHP+ members beginning July 1, 2021.

Read this information in a letter to providers here.