JANUARY 19, 2022
INSPIRE WELLNESS
NHP Provider Newsletter
In this issue:
  • COVID
  • Omicron Resources
  • CDC Recommends COVID-19 Boosters for Anyone 12 or Older
  • Update on Monoclonal Antibody Treatments: Supplies Limited
  • Colorado COVID-19 Health Care Provider Vaccine Information Toolkit
  • Statewide COVID Vaccine Information
  • Provider Resources and Information
  • Effective January 1, 2022: Updated Coding Manual
  • POS 10 Code Addition Effective January 1, 2022
  • Information for Health First Colorado and CHP+ Members Impacted by Boulder Fires
  • Notice from Northeast Health Partners Regarding Updated Fee Schedule
  • Updated Qualified Residential Treatment Program (QRTP) Billing Manual
  • NEW! PEAK Chatbot Features
  • Behavioral Health Provider Contracting Opportunity for Family First Program
  • New Utilization Management Program for Physician Administered Drugs
  • Letter to Providers Regrading Bed Count Data as Part of Enrollment
  • Beacon Health Options Transition to Availity Essentials Multi-Payer Portal
  • Housing Instability Resources for Members
  • Child Welfare Behavioral Health Programs
  • Focus on the Member Resources
  • Upcoming Events and Webinars
COVID
CDC RECOMMENDS COVID-19 VACCINE BOOSTERS FOR ANYONE 12 OR OLDER
 
On Jan. 5, 2022, the Centers for Disease Control and Prevention (CDC) approved the COVID-19 Pfizer booster for anyone 12 and older. The Colorado Department of Public Health & Environment encourages all Coloradans age 12 and up to get a booster dose as soon as possible if it has been at least six months since they got their second dose of Pfizer or Moderna, or at least two months since they got the Johnson & Johnson vaccine. 
 
As a reminder, children ages 5-11 are eligible for the COVID-19 vaccine. Vaccines and boosters are common practice in routine childhood vaccination. Many vaccines require multiple doses at specific intervals to be most effective. Anyone with questions about boosters is encouraged to speak with their health care provider.
 
Learn more about COVID-19 vaccines and boosters and where to find them. Anyone who needs help making a vaccine appointment should call 1-877-268-2926. Health First Colorado members who need help finding a ride to get to a vaccine appointment can use the Non-Emergent Medical Transportation benefit. 
UPDATE ON MONOCLONAL ANTIBODY TREATMENTS: SUPPLY LIMITED

Per Colorado Department of Public Health and Environment (CDPHE): Colorado’s supply of therapeutic treatments, including monoclonal antibody therapy and oral antivirals, is determined at the federal level. As of January 2022, the federal government is supplying an extremely limited quantity of these medications, significantly impacting the frequency at which we are able to provide them. We are hopeful that the supply of monoclonal antibody treatment and oral antivirals will ramp up significantly in the coming months.
 
For more information about therapeutic treatments, call the CDPHE hotline at 1-877-CO VAX CO (1-877-268-2926).
COLORADO COVID-19 HEALTH CARE PROVIDER VACCINE INFORMATION TOOLKIT

In an effort to best organize and make readily available the wide array of health care provider vaccine resources, trainings and materials related to the COVID-19 vaccination program, Colorado Department of Public Health and Environment (CDPHE) has created the online Colorado COVID-19 Health Care Provider Vaccine Information Toolkit. The toolkit has a variety of robust elements. Please share!
STATEWIDE COVID-19 VACCINE INFORMATION

Colorado Department of Public Health and Environment provides extensive resources and up to date information regarding the COVID vaccine. 
PROVIDER RESOURCES AND INFORMATION
EFFECTIVE JANUARY 1, 2022: UPDATED CODING MANUAL

Please review the attached documents for revisions to the Uniform Service Coding Standards (USCS) Manual. Providers must implement the January 2022 edition by January 1, 2022 for dates of service January 1st and thereafter, regardless of submission date.
PLACE OF SERVICE (POS) 10 CODE ADDITION EFFECTIVE JANUARY 1, 2022

Effective January 1, 2022, POS 10 will be added to reflect Telehealth Provided in a Patients Home. Additionally, the existing POS 02 has a description change.

POS Code / Name / Description

  • POS 02--Telehealth Provided Other than in Patient's Home--The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology.

  • POS 10--Telehealth Provided in Patient's Home--The location where health services and health related services are provided or received, through telecommunication technology. Patient is located in their home (which is a location other than a hospital or facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.

Here is the link to the official CMS Place of Service Publication.
INFORMATION FOR HEALTH FIRST COLORADO AND CHP+ MEMBERS IMPACTED BY BOULDER WILDFIRES

Health First Colorado and CHP+ will cover any needed medication refills for members whose medications have been destroyed, damaged or lost due to the recent Boulder fires. Members should contact their pharmacy to request medication refills. Please read the press release.
UPDATED NOTICE FROM NORTHEAST HEALTH PARTNERS REGARDING FEE SCHEDULE

Please read this updated notice from Northeast Health Partners regarding the increase in their fee schedule.
UPDATED QUALIFIED RESIDENTIAL TREATMENT PROGRAM (QRTP) BILLING MANUAL

Recent updates have been made to the QRTP billing manual. The following days are not billable:
  • The day of discharge. 
  • Days when the client is in detention.
  • Days when the client receives none of the services included in the per diem rate due to elopement.
  • Days the client spends away from the facility, due to an M1 hold or a temporary pass, but still receiving covered services, are billable for up to 4 days.  

The rest of the billing manual can be found here.
PEAK WEBSITE IMPROVED VIRTUAL ASSISTANCE FOR MEMBERS
 
The PEAK website, utilized by members to apply for or manage medical, food, cash or other State of Colorado benefits, has a new update for their chatbot. The PEAK Chatbot has the following new features that your clients will be able to use on the PEAK Websites:
  • Ability to find the provider directory
  • Ability to view your 1095B Correspondence 
  • Direction to your 211 information 
  • Direction on how you can change your PCP 
 
The flyers below were created to display in your lobby, post on Facebook, or share with members wherever you communicate with them. The PEAK Chatbot can answer many of your member's questions quickly and easily, hopefully reducing phone calls and lobby visits you get related to the information that the Chatbot can provide instead!
 

If you have any questions or concerns, please contact cbms.liaison@state.co.us.
ATTENTION BEHAVIORAL HEALTH PROVIDERS! CONTRACTING OPPORTUNITY FOR FAMILY FIRST PROGRAM
 
Beacon is looking for independent assessors for Family First Program (FFPSA). Learn more by reviewing the links below.
 
NEW UTILIZATION MANAGEMENT PROGRAM FOR PHYSICIAN ADMINISTERED DRUGS

Health First Colorado will be implementing a new utilization management (UM) program for the fee-for-service, physician-administered drug (PAD) benefit. Starting on Jan. 18, 2022, a select number of PADs will be subject to prior authorization (PA) requirements.
 
Keystone Peer Review Organization (Kepro) will offer various training sessions to providers within the coming months. Additional information will be sent via email, newsletters, and monthly provider bulletins, as well as posted to the ColoradoPAR: Health First Colorado Prior Authorization Request Program and Physician Administered Drug Provider Resources webpage.

After implementation, providers will need to submit a PA request to the UM vendor, Kepro, for any member receiving any of the PADs listed in Table 1. Providers must also ensure that an approved PA is on file prior to PAD administration. There must be an approved PA on file for each of the PADs requiring a PA that a member receives. Completed PA requests will be reviewed and responded to within 24 hours of receipt.
 
All PAD PA procedures and clinical criteria are on Appendix Y: Physician Administered Drug Medical Benefit Prior Authorization Procedures and Criteria. Providers will be required to follow all General Provider and PAD billing policies found in the PAD billing manual located on the Billing Manuals webpage.
 
Providers may contact the following entities related to PA, claims, and PAD benefit questions:
 
PA questions or concerns may be directed to Kepro
 
Claims questions or concerns may be directed to the Department's fiscal agent, Gainwell Technologies (formerly DXC Technology)
  • Phone: 1-844-235-2387
 
All other PAD benefit questions or concerns may be directed to HCPF_PAD@state.co.us
LETTER TO SUD PROVIDERS REGARDING BED COUNT DATA AS PART OF ENROLLMENT

Please utilize this letter from The Department of Health Care Policy & Financing in regards to the enrollment policy including addition of bed count information effective January 2022.
BEACON HEALTH OPTIONS TRANSITION TO AVAILITY ESSENTIALS MULTI-PAYER PORTAL

Beacon Health Options (“Beacon”) will be transitioning to the Availity Essentials Provider Portal. This portal provides a secure platform where providers can submit ANSI and HIPAA, as well as perform eligibility and benefit inquires, and check claim status. As we work to continuously improve the overall provider experience, Beacon will continually expand the platform to offer increased functionality.

Effective March 1, 2022, Availity Essentials will become the preferred portal for verifying eligibility and benefits, claim status and other secure transactions for Beacon.

On January 1, 2022, providers and facilities may begin submitting claims through the Availity Essentials Portal. Providers and facilities that are submitting through a clearinghouse other than Availity Essentials (i.e. Change Healthcare, Office Ally) can continue to do so as all existing clearinghouse trading partners will route claims through Availity Essentials to Beacon. Please be aware that it may take Beacon longer to process claims that are submitted through clearinghouses other than Availity Essentials. It is important to note that Beacon transactions through Availity Essentials are available at no charge to providers.

Please review the links below and share with those who need to know!
HOUSING INSTABILITY RESOURCES FOR YOUR MEMBERS

Beacon Health Options and Northeast Health Partners would like to contribute resources to providers to share with their members who may be in need of local housing and shelter assistance. Please provide this information to members who may benefit from these resources.
CHILD WELFARE BEHAVIORAL HEALTH RESOURCES

Beacon Health Options and Northeast Health Partners would like to contribute resources to providers to share with their members who may be in need of local child welfare behavioral health programs. Please provide this information to members who may benefit from these resources.
Northeast Health Partners Focus on the Member Resources
Beacon and Northeast Health Partners would like to give their providers important resources to share with members.
WHERE DO I START? WEBINAR--FOR NEW NORTHEAST HEALTH PARTNERS MEMBERS

Beacon and Northeast Health Partners will assist with questions new members have regarding Health First Colorado Medicaid benefits.
YOUR CHOICE, YOUR VOICE: LIFE CARE PLANNING ADVANCE DIRECTIVES VIRTUAL WORKSHOP

Beacon and Northeast Health Partners invites anyone to participate in this "working" workshop where forms are available for members to state their wishes if they were unable to communicate them.
UPCOMING EVENTS AND WEBINARS
RAE ROUNDTABLE BEHAVIORAL HEALTH---2nd Fri of every month at 11am

Click here to join the webinar.

Or By Telephone:1-669-900-6833---Webinar ID: 995 7438 8100---Passcode: 173943
Visit the NHP website for details on previous calls.
SUPPORTING TELEHEALTH AND TECHNOLOGY-ASSISTED SERVICES FOR PEOPLE WHO USE DRUGS--WEBINAR

This webinar will highlight innovative strategies and discuss resources and practices to overcome challenges related to implementing telehealth and technology-assisted supports. Attendees will hear from three experts in the field who have leveraged technology and virtual services to provide care and services to people who use drugs, including through mail-based harm reduction supply delivery, establishing Never Use Alone, a safer use hotline, and by providing telehealth-based treatment to people with opioid use disorder. Additionally, the resource guide, Supporting Telehealth and Technology-assisted Services for People Who Use Drugs, will be discussed.

  • Tuesday, January 25, 2022 11am - 12:30pm (MST)
  • Click here for more details and to register.
PROVIDERCONNECT CLAIMS--WEBINAR
Hosted by Beacon Health Options

This webinar is designed for providers and office billing staff who submit claims electronically by either batch or directly through ProviderConnect.

  • Wednesday, January 26, 2022 12pm (MST)
  • Click here to register.
QUESTION, PERSUADE, REFER (QPR) FREE ONLINE TRAINING
Hosted by Jefferson Center for Mental Health

QPR stands for Question, Persuade, and Refer — 3 simple steps that anyone can learn to help save a life from suicide. Just as people trained in CPR help save thousands of lives each year, people trained in QPR learn how to recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone to help. Those who attend will learn to:

  • Recognize the warning signs of suicide
  • Know how to offer hope
  • Know how to get help and save a life

Thursday, January 27, 2022 11am - 12:30pm Click here for more information and to register.
YOUTH MARIJUANA AND SUICIDE PREVENTION--LIVE EVENT
Hosted by Johnny's Ambassadors, Inc.

Johnny's Ambassadors educates the public about the dangers of today's high-THC marijuana on adolescent brain development, mental illness, and suicide. Join Laura Stack, Founder and CEO of Johnny's Ambassadors:

  • Learn About the High-Potency Marijuana Products Used by Today’s Youth
  • See the Results of Legalizing Medical Marijuana for 18-Year-Old’s in Colorado
  • Understand How Adolescent Marijuana Use Can Lead to Mental Illness and Psychosis
  • Understand the Connection Between Marijuana and Suicide in Youth

Tuesday, February 15, 2022 6pm-7:30pm (MST)
LIVE EVENT: Cornerstone Church, 9941 Lone Tree Pkwy, Lone Tree, CO 80124
Click here for more information and to register. Livestream is also available on the link.