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APRIL  2021

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

NEED TO KNOW
 
 
 
Provider Revalidation Update
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.

"Together We Protect": Colorado's COVID-19 Vaccine Equity Fund
This fund supports Colorado community-based organizations, working in partnership with state-contracted vaccine providers, to provide culturally relevant and localized outreach, information and support to ensure communities who face systemic barriers have access to the COVID-19 vaccine. Grants range from $10,000 - $100,000 and will be awarded to applicants from across Colorado. Learn more, including criteria and how to apply, here and here.
Free Transportation for COVID-19 Vaccine Appointments
Those with Health First Colorado (Colorado's Medicaid Program) can get rides to and from COVID-19 vaccine appointments through HCPF’s Non-Emergent Medical Transport (NEMT) program. Schedule a ride here, or call IntelliRide directly at 855-489-4999 or 303-398-2155 (State Relay 711).
COVID-19 Vaccine Hesitancy Video Series
New American Neighbors produced a video series, in several different languages, to address vaccination hesitancy. Each video highlights the facts that the vaccine is safe and effective and has been scientifically tested. Everyone is urged to get their vaccinations when they are available, but also to continue the good public health practices of wearing a mask, washing hands, and maintaining physical distancing. See the series here.
Support with Utility Bills
Energy Outreach Colorado provides utility bill assistance for households in the Denver metropolitan area who are behind on utility payments and may be at risk of not having home energy. If you have a patient who is struggling with bills, please have them call 866-HEAT-HELP (866-432-8435) or visit energyoutreach.org. Payments are made directly to local utility or fuel company. For more information, or to find a partner agency near you, click here.
Incorrect Member Billing
Health First Colorado members cannot be billed for services that are covered. You cannot bill members in the
following circumstances:

  • Third-party liability (TPL) copays and deductibles
  • Delayed notification of eligibility from the member
  • Claim denials
  • Provider is not enrolled with Health First Colorado
For more information, click here.
Colorado NPI Law
A new Colorado National Provider Identifier (NPI) law took effect January 1, 2021. HB 18-1282 requires providers who are newly enrolling or currently enrolled to obtain and use a unique NPI for each service location and provider type enrolled in the Colorado interChange. Click here for more information.
Colorado Access Provider Portal Updates:
New Security Features

This month, we are implementing two new security features: 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. Access the portal here.
Increases in Medicaid Reimbursement for All
COVID-19 Vaccines
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.
Trainings
  • 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.
COVID-19 Resources

For COVID-19 utilization management information, click here.

For COVID-19 pharmacy information, click here.

For COVID-19 administrative information, click here.

For COVID-19 training information, click here.

For COVID-19 practice support information, click here.


HEALTH EQUITY
 
 
 
Connecting the Dots: Social Determinants of Health
Be sure to check out our new article series in the second issue of the Navigator each month.
This new series will illuminate social factors that lead to health inequalities and disparities,
or help to decrease them. We hope this monthly series will support your existing efforts by providing resources and educational opportunities while exploring current trends and best practices.

Crisis Resource Navigation
The Center for African American Health has a program called Crisis Resource Navigation for people struggling with the pressures caused by COVID-19. This program is designed to support individuals by connecting them to helpful resources, providing emotional support, and helping develop coping strategies. All services are free. For more information send an email to connect@caahealth.org, or call 720-780-5619.
ECHO Series: Transgender Health: Comprehensive Approaches in Primary Care
This series is designed to support clinical providers who wish to improve care for transgender and gender non-binary patients. You will increase your knowledge and confidence in providing gender-affirming care including routine primary care, hormone therapy management, surgical options and supporting mental health. This series meets the first Thursday of each month from 12:00 p.m. to 1:00 p.m., until January 6, 2022. Find more information or sign up here.
ECHO Series: Perinatal Mental Health: An Interdisciplinary Approach
This new series focuses on perinatal mental health and developed for physicians, APNs, and PAs who care for pregnant or postpartum Coloradans. Registration is now open for this series. Find more information or sign up here.
 
PROGRAMS
 
 
 
USCS Coding Manual
The new, quarterly, edition of the USCS coding Manual is now available. You can find it here.
Well Visit Reimbursement
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
    1. Place of Service 02 must be indicated on all professional claims for well visits delivered by telemedicine.
    2. 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
  1. 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.
  2. 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.
  3. Outpatient hospitals may not bill facility claims for telemedicine well visits.
  4. 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.
Depression Screen Workflow
Check out our new document "Creating a Workflow for Depression Screens & Follow Up Treatment" here.
COVID-19 Vaccine Locations
In Colorado, everyone ages 16 and older is now eligible for the COVID-19 vaccine. Find out where you can get yours here.
 
State Managed Care Network
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:
    1. 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.
    2. 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.
    3. 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.

 
 
 
 
 
11100 E. Bethany Dr.
Aurora, CO 80014

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