October 2023

Case Manager's Corner

Care and Case Management (CCM) System News

Frequently Asked Questions

New FAQs are posted to the CCM FAQ webpage on a regular basis. The page includes an index where each FAQ is organized by system functions. The index is also searchable, so you can click on a keyword to find FAQs relevant to your question. Each FAQ includes its publish or update date in red. Be sure to bookmark the link if you haven’t already and visit regularly for the most up-to-date information. 

Training Resources

There is a new “Introduction to the CCM” recording in our training folder. CMAs should use Google Drive to access all CCM training materials including recorded demos. Please note the CCM system training is no longer available on the LMS. 

We have posted new Job Aids for: 

  • Access to a Member's Record- On pages 4-5 Steps 3 & 4 have been updated to identify "Medcompass CMA" as the recommended filter option for Provider type. 
  • Activity Logs- Page 3 Step 1 has been updated to clarify contact date vs event date. Page 5 Step 3 has been updated to reflect the fields required for CMA billing purposes.
  • Completing the Utilization Review Contractor Process- On page 4 a new section was added with the heading "Viewing Printout of Legacy 100.2".
  • State General Fund Programs- Page 2 Step 3 was updated to reflect the documentation required to be uploaded in the CCM for FSSP members. 

HCPF has created a Google form to request changes or updates to the current System Job Aids

Other News

Telligen Office Hours 

During November’s Telligen Office Hours, the Department of Health Care Policy & Financing (HCPF) will be providing training on the Utilization Review / Utilization Management (URUM) process for the below review types: 

  • Health Maintenance Activities 
  • Over Cost Containment 
  • Supported Living Services (SLS) Exception 

This training is intended for new case managers and case managers who seek additional information about the URUM process. The following topics will be covered:

  • What is URUM? 
  • Preparing for a Review 
  • Submitting a Review
  • Requests for Information
  • Post-Review Next Steps – including when to send a Long-Term Care Notice of Action

Meeting Details 

9:30 - 11 a.m. 

Nov. 16, 2023  

Please register to join. 

Each attendee should register individually. Questions and answers from previous office hours are on our webpage under Telligen Office Hours. Please send any questions about the URUM Training to hcpf_pdp@state.co.us

Support Level Review Reminder

When submitting a Support Level Review (SLR) to HCPF, please use the most up-to-date form. The form was updated in May 2023 and should be the form submitted to HCPF for the SLR panel to review. Please be sure to replace any outdated forms with the current one. Use this guide to help you complete this form if needed.

Ensure all fields are completed, if something does not apply, "n/a" should be entered into the field, so the panel knows this was not missed. For additional information on Long-Term Services and Supports Case Management Forms and Tools, visit this webpage.

New Children's Habilitation Residential Program Residential Child Care Facility: Tennyson Center for Children

Tennyson Center for Children is now accepting referrals for youth ages 6-12 through the Children's Habilitation Residential Program (CHRP) Habilitation in their Residential Child Care Facility (RCCF) setting; referral contact information is on the CHRP Provider List.

 New Referral Form for CDASS

As a reminder, the referral form for CDASS members has been updated and added to Consumer Direct’s website. Click here to view and save the form.

Please be sure to use this updated form as it reflects the new email addresses for FMS (Financial Management Services) contractor PPL (Public Partnerships). Consumer Direct is only accepting this updated form moving forward and will not process a referral with an outdated form. Questions can be sent to Consumer Direct via email.

Helping Members Throughout the PHE Unwind

HCPF has developed extensive partner toolkits regarding the end of the continuous coverage requirement. Materials in the toolkits identify key actions for members to take: updating contact information, taking action when a renewal is due, and seeking help with renewals at community or county resources when they need it. Flyers, social media messaging and graphics, website content, and other outreach tools are in our PHE Resource Center

You can help us raise member awareness about the renewal process by sharing the messaging in our toolkits. 

Partners can educate themselves on the basics of the renewal process to assist members who may need help. See our Renewal Education toolkit

Frequently Asked Questions (FAQs) about the end of the continuous coverage requirement and return to regular renewal processes have recently been added. Members with questions about the renewal process can learn more by visiting Health First Colorado’s renewal webpage available in English and Spanish

Sign up for the COVID-19 Public Health Emergency Updates Newsletter to stay informed about the PHE Unwind. 

A special thank you for your partnership and continued collaboration!

Notice of Action Letter Updates 

LTC Notice of Action Operational Memo

A new Operational Memo will be developed that will supersede the PHE Memo that went out in 2020 regarding Notice of Actions (NOA)s (HCPF OM-045 Eligibility and Notice of Action Changes). The purpose of this Operational Memo will be to inform Single Entry Points (SEPs), Community Centered Boards (CCBs) and Case Management Agencies (CMAs) of operational changes to case management requirements for issuing a Notice of Action (LTC-803) for a member’s functional eligibility. At this time, a Level of Care Eligibility Approved Notice of Action should be sent for Initial assessments only, and do not need to be completed for annual Continued Stay Review Level of Care assessments unless the member no longer meets Level of Care.  

Notice of Action forms in the Care and Case Management System

At this time, the Merge and Send feature in the CCM for Notice of Action letters should not be used. Please do not attempt to use the CCM in order to mail out Notice of Action letters until notified by HCPF. Notice of Action letters are currently posted on the Long-Term Services and Supports Case Management Forms and Tools Page. Please continue to use the LTSS CM Tools Webpage link to ensure that the NOA letter you are using is the most up to date. 

Member Certification Period

Case Management Agencies should continue to ensure that an LTC Notice of Action is completed and sent to the member if a Continued Stay Review/Person-Centered Service Plan is not completed within a minimum of eleven (11) days prior to the end of the current Certification Period. This includes when a county or eligibility site has not verified financial eligibility. The LTC Notice of Action sent by a Case Management Agency in this circumstance is not a Notice of Action regarding the member’s financial eligibility, but rather, is a Notice of Action to inform the member that their Person-Centered Support Plan is not completed before the end of their current certification period. 


Case managers should verify that a member has filed an appeal with the Office of Administrative Courts for the adverse action which will allow the member to continue receiving services as approved in their previous Person-Centered Service Plan through the appeal period. No changes in services may be made for the Person-Centered Service Plan for a member through an appeal period; the Person-Centered Service Plan must be entered exactly as it was in the previous certification period.

CMAs should also be aware that if a member has been notified via a Notice of Action from the county or eligibility site that they are no longer eligible for Health First Colorado benefits and they file an appeal with the Office of Administrative Courts, they are also eligible to continue receiving services as previously approved in their Person-Centered Service Plan through an appeal period. Case managers should verify that a member has filed an appeal with the Office of Administrative Courts for the adverse action which will allow the member to continue receiving services as approved in their previous Person-Centered Service Plan through the appeal period. No changes in services may be made for the Person-Centered Service Plan for a member through an appeal period; the Person-Centered Service Plan must be entered exactly as it was the previous certification period.

In the event that a member receives a Notice of Action, that member has the right to appeal the action that is outlined in their Notice of Action letter. If a member is receiving services, and appeals an action before their services are set to end or decrease, they may continue to receive their waiver services until a final decision is made on their appeal. The member must ask their case manager for their services to continue within 10 calendar days from the date on their NOA letter, or before their services are scheduled to end. 

In order for a member to request continued coverage in CBMS, the member must first notify their case manager within 10 calendar days of the date on their Notice of Action letter that they would like their services to continue. The member must also follow instructions on their Notice of Action letter and return it to the Office of Administrative Courts to initiate the appeal process. After the appeal has been received and initiated, HCPF eligibility and appeals staff add a continuation of benefits in CBMS which allows member to remain locked into their LTC coding until a determination is made on their appeal. This allows members to continue receiving their state plan benefits and services throughout the appeal period. Case managers should submit a County and Eligibility Site Member Complaint and Escalation Webform to notify HCPF that they have received verification that a member has filed an appeal with the Office of Administrative Courts and HCPF level manual override is necessary to activate LTC Medicaid so a Person-Centered Service Plan can be entered in the InterChange.

In the event that a member requests to continue receiving services during their appeal period, they may do so. Regardless of the outcome of the appeal hearing, the member will not be responsible for “paying back” any of the funds that were allocated to their services during that appeal period. Any language regarding the need to “pay back” services if a member does not “win” their appeal has been removed from all up-to-date Notice of Action templates.

Level of Care and PMIPs

Please do not complete a Notice of Action regarding an Initial Level of Care assessment until (1) the LOC 100.2 assessment has been completed, and (2) a completed Professional Medical Information Page (PMIP) has been obtained by the Case Management Agency. We want to prevent unnecessary appeals or escalations in which the member is notified that they meet or do not meet Level of Care requirements prior to both of these steps being completed.

Contact Us

  • Please send questions about the new CCM system and Colorado Single

     Assessment & Person-Centered Support Plan to our CCM inbox.