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HCI Provider Newsletter
A monthly collection of must-know information and resources
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In this issue:
- Provider Resources and Information
- March is National Colon Cancer Awareness Month
- Affordable Healthcare for Coloradans
- Continued Coverage: Take Action Toolkit
- Screening, Brief Intervention, Referral to Treatment (SBIRT) Training
- HCI Coordination of Care
- Behavioral Health Stipend Fund
- Provider Services Call Center Verification Update
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Health Colorado COVID-19 Vaccination Contest Description
- Billing Health First Colorado Members for Services
- Care On Location: Bridge Care Program
- HCPF Provider Bulletin Index
- CAHPS Member Survey Information
- Member Complaint and Appeal Information for Providers
- Health Colorado Member Resources
- Health Colorado Website
- Early and Periodic Screening, Diagnostic and Testing (EPSDT)
- Broadband Discount Program
- Where Do I Start Webinar
- Care on Location: Material Opioid Misuse Project
- Public Health Information
- New COVID-19 Counseling Codes
- Monkey Pox (M Pox) Resources
- Public Health Emergency Information -- Planning and Renewals
- COVID-19 Outpatient Therapeutics Flowsheets and Resources
- Colorado COVID-19 Health Care Provider Vaccine Information Toolkit
- COVID-19 Therapeutics Program For Health Care Providers
- Statewide COVID-19 Vaccine Information
- Upcoming events and webinars
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PROVIDER RESOURCES AND INFORMATION | |
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MARCH IS NATIONAL COLON CANCER AWARENESS MONTH
Every March, the Colon & Rectal Clinic of Colorado observes Colorectal Cancer Awareness Month, spreading mindfulness, promoting regular screenings, and educating about the risks of colorectal cancer. Colorectal cancer is the third most common cancer in the United States, and the second leading cause of death from cancer. It is most often found in people over the age of 50, affecting men and women of all ethnic groups. However, younger demographics, millennials especially, have seen a dramatic rise in diagnoses over the past four years. Most colon cancers first develop as polyps, abnormal growths in the colon or rectum that can become cancerous if not removed or treated. You can find more information about Colorectal Cancer by visiting the Colon & Rectal Clinic of Colorado's webpage.
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AFFORDABLE HEALTHCARE FOR COLORADANS
The Department of Health Care Policy & Financing is holding a summit focused on keeping healthcare affordable for low income and disabled Coloradans. This summit will cover a list of high-priority topics which include keeping Coloradans covered through the end of the public health emergency. You can find more information on this summit on the Affordable Health Care for Coloradans HCPF Webpage.
Summit Webinar: March 15, 2023 at 7:30am MST
Registration Here
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CONTINUED COVERAGE: TAKE ACTION TOOLKIT
Please tell your members to take action to keep their Health First Colorado (Colorado’s Medicaid program) or Child Health Plan Plus (CHP+) coverage! Health First Colorado and CHP+ is returning to normal renewal processes. Your members can take steps now to make sure they get the information they will need to continue your coverage.
Not all members will be renewed at the same time. Colorado will take 12 months (14 months including noticing) to renew members based on their annual renewal date. Some people will be automatically renewed based on the most recent information already on file with the state. Other people will need to take action and complete the renewal packet to see if they still qualify for Health First Colorado or CHP+.
Please share Communications Toolkit (English | Spanish) with your members for their continued coverage.
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SCREENING, BRIEF INTERVENTION, REFERRAL TO TREATMENT (SBIRT) TRAINING
Peer Assistance Services, Inc. provides interactive training for health and mental health professionals on the evidence-based approach of Screening, Brief Intervention, and Referral to Treatment. Screening assists providers in identifying and intervening with patients at risk for health problems due to alcohol and other drug use. Please see the SBIRT Training Flyer for more information and to sign up for a training.
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HCI COORDINATION OF CARE
HCI care coordination involves identifying the needs of members, prioritizing those with complex care needs and chronic conditions, and providing them with the care and resources that meet these needs. Central to the transformation of care coordination is implementing a holistic care management and care navigation system. This entails the identification of member care coordination needs (using standardized assessments, data analysis, and predetermined conditions), working through care coordination entities to reach identified members, and supporting members with their health needs (care management, care transitions, care navigation, care providers, resources, etc.). Care coordination is non-duplicative of internal Primary Care Provider or Behavioral Health Provider care coordination. HCI care coordination services are free and are included in members’ Medicaid benefits.
In HCI’s model, care coordination is further subdivided into care navigation and care management teams that possess the following specific care coordination competencies. For further information on care coordination, care navigation, and care management, please review this factsheet.
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BEHAVIORAL HEALTH STIPEND FUND
Serving Chaffee, Custer, Fremont, and Park Counties
The region 15 Opioid Settlement Governance Committee has created a Stipend Fund of $6000/year/person (max 2 years) to help behavioral health providers tackle the high cost of living in our area. This opportunity is available directly to individual providers who will be considered whether they work for an established behavioral health organization or are an independent practitioner.
To apply, please fill out this application.
FOR QUESTIONS OR TO REQUEST AN APPLICATION, PLEASE CONTACT CAROL TOGIE AT PARK COUNTY PUBLIC HEALTH:
Email: CTogie@parkco.us
Office: 719-836-4149
Mobile: 719-839-0246
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PROVIDER SERVICES CALL CENTER VERIFICATION UPDATE
An additional verification will soon be required when a provider contacts the Provider Services Call Center. The fiscal agent is now asking for the caller to provide an 8- to 10-digit Health First Colorado (Colorado’s Medicaid program) ID and the National Provider Identification (NPI) (if applicable) to release Health Insurance Portability and Accountability Act (HIPAA) protected information.
- Providers whose enrollment types or specialties do not require an NPI may authenticate using their Health First Colorado ID only. If the caller is a submitter or trading partner calling for electronic data interchange (EDI) support, the term “EDI” can be used in order to be directed into the correct queue. Once connected to an agent, the Trading Partner ID (TPID) will be required for authentication.
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HEALTH COLORADO COVID-19 VACCINATION CONTEST
Health Colorado, Inc. (HCI) is holding a regional COVID-19 Vaccination Contest to reward the top five Primary Care Organizations with the most improved vaccination rates in 2023. Current studies reveal that vaccinations have the largest impact on COVID-19 death rates as well as hospitalization rates, both at the ICU and non-ICU levels. Despite this, only 33% of HCI members are fully vaccinated for COVID-19.
HCI will reward the top five Primary Care Organizations across the region that demonstrate the greatest COVID-19 vaccination improvement based on contest logic below.
- $30,000 to the top performer
- $25,000 to the second highest performer
- $20,000 to the third highest performer
- $10,000 to the fourth highest performer
- $5,000 to the fifth highest performer
Health Colorado has provided this contest description with further details.
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ATTENTION! BILLING HEALTH FIRST COLORADO MEMBERS FOR SERVICES
It is important that all health care providers know that Health First Colorado members cannot be billed for services covered by Health First Colorado. Please visit this policy statement for more detailed information.
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CARE ON LOCATION: BRIDGE CARE PROGRAM
HCI is partnering with Care on Location to build a Bridge Care program that supports Hospital Transformation Program (HTP) initiatives and RAE 4 Access to Care standards which are amenable to telehealth modalities and care coordinators being able to connect patients directly to a care source.
Goals:
- Strengthen care transitions and bridge access to care gaps in a timely manner
- Respect local resources and workflows that already exist
- Extend access to care to those who are often lost through the cracks
Additional information and resources:
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CAHPS MEMBER SURVEY INFORMATION
The State of Colorado will be administering the Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey (CG-CAHPS) beginning December 20th, 2022, and concluding on May 23rd, 2023. We would like to inform providers of the possibility that Health First Colorado members attributed to your practice may be identified as a survey respondent for the CAHPS survey.
Please encourage your Health First Colorado Members to complete the CG-CAHPS, if surveyed. More information about to assist members to complete this survey can be found in the Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey (CG-CAHPS) memo.
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HCPF PROVIDER BULLETIN INDEX
The Provider Bulletin is published monthly and posted to this web page. The bulletin covers topics of interest to providers and billing professionals. For access to the Provider Bulletin Index, please visit the HCPF website.
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PROVIDER HANDBOOKS
As a reminder, you can access The Provider Handbook on Health Colorado's website under the Provider Handbooks & Policies section. Please utilize these resources to answer questions in regards to covered services, claims, provider information, etc.
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MEMBER COMPLAINT AND APPEAL INFORMATION FOR PROVIDERS
Health First Colorado members have the right to file a complaint at any time and also have the right to file an appeal. Please familiarize yourself with the following document in the event a member has questions. You will then be able to direct them appropriately. This can also be found on the Health Colorado, Inc. website.
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HEALTH COLORADO MEMBER RESOURCES | |
Carelon and Health Colorado would like to give their providers important resources to share with members. | |
HEALTH COLORADO WEBSITE
Health Colorado's website provides many resources for members to access to keep up with their health and wellness. Get access to all things member related here and share as needed. | |
EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT (EPSDT)
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for Health First Colorado (Colorado's Medicaid Program) members age 20 and under. EPSDT is key to ensuring that children and youth receive appropriate preventive, dental, mental health, developmental and specialty services. Click here for a flyer with more information.
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HEALTH COLORADO: WHERE DO I START? WEBINAR
Carelon and Health Colorado will assist with questions new members have regarding Medicaid benefits.
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CARE ON LOCATION: MATERNAL OPIOID MISUSE PROJECT
Leverages strong community relationships in SE CO to establish a community-based, co-location to facilitate medical navigation and social support to pregnant and postpartum women with an OUD with PEERs and those with lived experience.
The Care on Location team also has a test to treat page for more information on COVID-19 with the increased cases. Their providers are able to evaluate for risk factors, coordinate with pharmacies that have medication available and also provide further guidance on supportive therapies OTC.
More information:
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PUBLIC HEALTH INFORMATION | |
NEW COVID-19 COUNSELING CODES
The Colorado Department of Health Care Policy and Financing have uploaded new COVID-19 counseling codes that are ready to use. Please reference the links below for more information.
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MONKEY POX (M POX) RESOURCES
The Centers for Disease Control (CDC) has a webpage with Monkey Pox information, resources and vaccine information.
The Colorado Department of Public Health & Environment (CDPHE) also has a webpage with local statistics and information as well as a social media toolkit which is encouraged to share with the public.
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PUBLIC HEALTH EMERGENCY INFORMATION--PLANNING AND RENEWALS
Another extension started January 11, 2023, and if extended the full 90 days, runs through April 11, 2023. HHS has confirmed that they will provide 60 days advance notice before an end to the PHE. If the PHE will end on April 11, 2023, we expect to receive 60 days advance notice by Feb. 10, 2023.
Although the PHE was extended, Congress passed legislation that ends the continuous coverage requirement, allowing states to resume their eligibility renewal process for Medicaid members. This means members who are no longer eligible for Health First Colorado or fail to return renewal paperwork, may lose their benefits. Colorado intends to follow federal guidance and plans to take 12 months (14 months including noticing) to renew members based on their annual renewal date. It will be critical for members to complete renewal packets when their renewal is due. Please be sure to remind members to update their contact information to ensure they receive their renewal packets in a timely manner. For more information on what to do to help members, please visit the PHE Planning page on the HCPF website.
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COVID-19 OUTPATIENT THERAPEUTICS FLOWSHEETS AND RESOURCES
The Colorado Department of Public Health and Environment has provided the following checklists with resource documents which is intended to assist prescribing providers with their assessment of the utilization of these particular therapeutic selections.
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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, the 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 for providers to use.
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COVID-19 THERAPEUTICS PROGRAM FOR HEALTH CARE PROVIDERS
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STATEWIDE COVID-19 VACCINE INFORMATION
Colorado Department of Public Health and Environment provides extensive resources and up to date information regarding the COVID vaccine.
For vaccine information from the Colorado Department of Public Health and Environment, visit this webpage.
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UPCOMING WEBINARS AND EVENTS | |
Carelon / HCI Webinars / Events | |
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CARELON (BEACON) UPCOMING WEBINAR AND ARCHIVE
Every month, Carelon hosts training webinars about various topics. To sign up for upcoming webinars, or to view recordings of previous webinars in the Carelon archive, please visit the Beacon Health Options Trainings webpage.
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RAE ROUNDTABLE BEHAVIORAL HEALTH---2nd Fri of every month at 11am
Or By Telephone:1-669-900-6833---Webinar ID: 995 7438 8100----Passcode: 173943
Visit the HCI website for details on previous calls.
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IN CASE YOU MISSED IT: RAE ROUNDTABLE RESOURCES
If you were unable to attend a previously hosted RAE Roundtable, please visit this Health Colorado Inc's website for information. February’s provider support call included information about Member-Centered Care, Continuous Coverage Updates, Language Service Support/Health Equity/Cultural Competency, Complaints/Appeals – members & provider info, Member Rights/Responsibilities, and Benefits/EPSDT/Title V.
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