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MAY 2025
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At Colorado Access, caring for you and your success is our top priority as you serve our members. This monthly Provider Update serves as a highlight of important information and resources to help you as a contracted provider with us. |
Accountable Care Collaborative (ACC) Phase III Updates
Accountable Care Collaborative (ACC) Phase III will begin in July 2025, and we want to keep you informed on what you need to know. Please make sure to check this section each month for updates that may affect you. Stay updated about previously shared information from Colorado Access here. |
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ICYMI: Last week we shared important ACC Phase III updates. Find that information here.
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May 2025: Are you a Health First Colorado (Colorado’s Medicaid program) provider currently contracted with one or more Regional Accountable Entity (RAE)? If you’d like to continue providing services for Health First Colorado members, the Department of Health Care Policy and Financing (HCPF) has resources to help you:
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Physical and Behavioral Health |
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Revalidation Reminder: Name Matching
The name submitted during revalidation must be identical across the Application Tracking Number (ATN), provider documentation, and verification databases. ATNs will be denied if the name does not match across all documentation and verification databases. If you need to update a name, you must submit a maintenance request. After confirming that the name matches, then you can submit the revalidation application. Learn more here. |
Health First Colorado Behavioral Health Updates Newsletter
The latest edition of the Health First Colorado Behavioral Health Updates newsletter is available here. |
Billing Tips
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Professional providers: When billing your professional services, please do not list any credentials (i.e. LPC, PhD, LCSW, LMFT, MA, etc.) in the first name or last name fields for the rendering provider, as this will cause a denial and/or a delay in payment.
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Facility providers: When billing NDC codes, please ensure that you are billing complete and valid codes to ensure your claim is not rejected and or denied.
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Colorado Medicaid eConsult
Health First Colorado providers, you have access to a free and secure statewide electronic consultation platform on coloradomedicaideconsult.com (eConsult), where you can communicate electronically with specialty providers. This frequently eliminates the need for in-person referrals for members.
To learn more about the platform, go to the eConsult platform webpage, or email the eConsult team at hcpf_econsult@state.co.us.
To enroll in eConsult, fill out the practice enrollment form or register for an upcoming webinar:
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June 3, 2025, from 12:30 to 1:00 p.m.
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July 1, 2025, from 12:30 to 1:00 p.m.
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August 5, 2025, from 12:30 to 1:00 p.m.
If you have any questions, please email coloradosupport@safetynetconnect.com. |
Behavioral Health Provider Resources From HCPF
The Behavioral Health Initiatives and Coverage (BHIC) office at HCPF hosts ongoing forums, meetings, and office hours for behavioral health providers. View their calendar here. If you have any questions or want to learn more, email hcpf_bhbenefits@state.co.us. |
Claims Submitted With Medicare Advantage Primary
If a member has a Medicare Health Maintenance Organization (HMO) (an advantage plan or replacement plan), the primary billing information should be reported on a claim in the Medicare fields and not in the Third-Party Liability (TPL) fields. A Medicare Advantage plan (such as an HMO or Preferred Provider Organization (PPO)) is another Medicare health plan choice a member may have as part of Medicare. Learn more here.
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News From HCPF |
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Provider Call Center Transition
On May 1, 2025, Optum officially took over management of the Provider Services Call Center. |
What is different:
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Phone number: Is now 833-468-0362. This was updated on the Provider Contacts webpage.
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Business hours: Have changed to 8:00 a.m. to 5:00 p.m. Monday through Friday.
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Vendor: Contact Optum (instead of Gainwell Technologies) if you need help.
What is the same:
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Processes: Are the same. Optum agents can help with any of your Provider Services Call Center needs, including billing and claims submissions, member eligibility, enrollment, revalidation, or technical support for the Provider Web Portal. Make sure to note the “case number” the agent gives you when you call, in case the agent needs to do more research, or you need to make a follow-up call.
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HCPF Web Portal Updates
The homepage of the HCPF Provider Web Portal and the Quick Guides webpage both have a new self-service web form to reset your password. The Provider Services Call Center will not be able to reset passwords.
For the first time you make any changes to your profile during maintenance or revalidation:
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Group and facility providers are required to identify their “primary owner”
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Individual Within a Group (IWG) and Ordering, Prescribing, and Referring (OPR) providers are required to identify their “Primary Employer”
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Medicaid Reimbursement for Community Health Worker (CHW) Services
Due to the State’s budget shortfall, the Colorado General Assembly passed legislation (SB 25-229) that postpones CHW Medicaid reimbursement until January 1, 2026. The Medicaid reimbursement for CHW services will not begin on July 1, 2025, but will instead begin on January 1, 2026.
While the CHW benefit will be paused for at least six months, HCPF has other Health First Colorado resources:
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Community-based organizations (CBOs) and medical providers with CHWs on staff, contact your RAE about any collaboration opportunity for CHW services. RAE contracts encourage RAEs to develop a network of CBOs to support care coordination work and to prioritize CBOs that employ CHWs.
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Medical providers who are currently enrolled with HCPF can use any of the following resources:
If you are interested in any additional information or have questions, please email hcpf_chw_benefit@state.co.us. |
News from Colorado Access |
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Upcoming Changes in Behavioral Health Billing Under ACC Phase III
As part of ACC Phase III, significant updates are coming for how behavioral health providers bill for integrated services in primary care settings.
Join us on Thursday, June 5, from 12:00 to 1:00 p.m. for an education session to help you prepare for these changes. We’ll review updates to the Short-Term Behavioral Health (STBH) benefit, outline billing processes for integrated care, and share the latest information on two new services launching July 1, 2025:
Click here to register.
*After registering, you will receive a confirmation email containing information about joining the meeting. |
Online Directory
Is your information correct in our online directory where members search for care? Please go to our online directory, search for yourself, and check that your data is accurate. Use the form at the top of the page to report any discrepancies, or email updates to providerdatamaintenance@coaccess.com. |
Clinical Update Form
Our clinical update form is now available online. Through this new digital tool, you can submit requests to add, update, or terminate provider information. Learn more here. |
Join Our Provider Advisory Groups
We are looking for providers with diverse perspectives to serve on our advisory groups. We invite you to apply if you can share your suggestions and understandings to improve the health care experience and outcomes for Health First Colorado and Child Health Plan Plus (CHP+) members. Learn more here.
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Behavioral Health Town Hall Webinar
Please join us for our monthly Behavioral Health Provider Town Hall Webinar on Thursday, June 12 at 12 p.m., where we'll share updates, provide information and training, and answer your questions. Feel free to share this invitation with colleagues who may also be interested in attending. Click here to register.
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Health Care News Highlights |
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Colorado Refugee Services Program (CRSP)
Click here to view program data for federal fiscal year 2024 (October 1, 2023 through September 30, 2024). Click here to view the updated statewide organizational directory. This resource has more than 90 organizations statewide with dedicated programs and services for refugees. Use the filter at the top to search by region of the state, city/town, or program area. |
UCHealth Community Health Benefit Public Meeting
UCHealth is hosting community benefit public meetings to share how they are addressing local community health issues. The next one is on Tuesday, May 27, from 12:00 p.m. to 1:00 p.m. at Parkview Medical Center. Click here to learn more. |
