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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
- Provider Revalidation Timelines
- #KeepCOCovered
- Maternity Care Providers: Provider listening sessions
- Care and Case Management (CCM) System
- HCPF Provider Bulletin Index
- HCI Provider Handbooks
- Member Complaint and Appeal Information for Providers
- Health Colorado Member Resources
- DentaQuest Member Information
- Navigation Assistance for Colorado Medicaid Members
- 2-1-1 Get Connected Get Help
- Understanding Lead
- Member Wellness & Prevention Resources
- Health First Colorado Member Renewal Packets
- Member Engagement Opportunities
- Health Colorado "Where Do I Start" Webinar
- Public Health Information
- Accountable Care Collaborative: Phase III
- Member Co-Pay Reduction
- Provider Trainings
- Upcoming events and webinars
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PROVIDER RESOURCES AND INFORMATION | |
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PROVIDER REVALIDATION TIMELINES
Revalidation due dates may be delayed by the amount of time the Public Health Emergency (PHE) was in place with an additional six months for those revalidation due dates that occurred during the PHE.
Effective November 12, 2023, the flexibility that paused disenrollment for providers past their revalidation date during the COVID-19 PHE is ending. Providers with revalidation due dates of October 1, 2020, through November 11, 2023, will be given a post-PHE grace period to complete the revalidation process.
Providers will be notified of their new revalidation date. Providers will be sent another notification 6 months prior to their revalidation date. Providers with revalidation due dates between October 1, 2020, through November 11, 2023, with no claims activity in the last 3 years must revalidate by November 11,
2023.
Providers that do not complete the revalidation process by their revalidation due date will be subject to claim denials or disenrollment.
Providers with revalidation applications that are currently in process must complete the process by November 11, 2023, or by their revalidation date, whichever comes first.
Visit the Revalidation web page for more information.
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#KEEPCOCOVERED
Health care providers and others who provide support services to Medicaid members should remind their Medicaid customers to look for and complete their Medicaid renewals this year and seek other coverage options if they no longer qualify for their current coverage. HCPF requests the health care industry to work together to make sure we keep Coloradans covered by getting them connected and enrolled into affordable health coverage options. For outreach resources and financial eligibility guidelines, please see: https://hcpf.colorado.gov/keepcocovered
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MATERNITY CARE PROVIDERS: PROVIDER LISTENING SESSION
Do you provide prenatal, birth, and/or postpartum care in your community? Whether you’re an OB/GYN, doula, nursing professional, or other supporting perinanatal care provider, we are interested in your thoughts and reflections on providing perinatal care in your community.
The Colorado Department of Health Care Policy & Financing, Colorado’s Medicaid agency, would like to hear from you. As a follow up to our 2020 Maternal Health Equity Report, the Department is hosting a series of regional provider listening sessions. We’ll briefly present our data on recent health trends among birthing people in your region and invite you to share your experiences. Your input will inform our next report on maternal health care experiences and outcomes for Colorado’s Medicaid members.
Date: Thursday, September 28
Time: 12:00pm - 1:00pm MST
Location: Zoom - Register here
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CARE AND CASE MANAGEMENT (CCM) SYSTEM
The CCM System became available to Case Managers on Wednesday, July 5, 2023. Visit the Known Issues web page to review details about all known issues under the Case Manager drop-down. Beginning August 21, 2023, users should no longer contact the Gainwell Provider Services CCM Call Center to report issues with the system. Please submit requests for support by completing and submitting a CCM Support Request. Requests for password resets should be submitted to commit_helpdesk@gainwelltechnologies.com.
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HCPF PROVIDER BULLETIN INDEX
The HCPF 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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HCI 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 visit the HCI website for more information to assist a member when needed. https://www.healthcoloradorae.com/members/complaints-appeals/.
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HEALTH COLORADO MEMBER RESOURCES | |
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DENTAQUEST MEMBER INFORMATION
DentaQuest provides dental coverage for Medicaid-eligible members of Health First Colorado including children, pregnant women, parents and caretakers, people with developmental, intellectual, and physical disabilities, and adults. Please visit Dentaquest website for more information.
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NAVIGATION ASSISTANCE FOR COLORADO MEDICAID MEMBERS
Thanks to a grant from Health Colorado (Region 4 RAE), SRDA is able to offer resource and benefit navigation assistance to Medicaid members. Please visit Senior Resource Development Agency for more information.
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2-1-1 GET CONNECTED GET HELP
2-1-1 is a confidential and multilingual service connecting people to vital resources across the state such as basic needs, housing/shelter, food assistance and much more . No matter where you live in Colorado, you can find information about resources in your local community. Please visit 2-1-1 Colorado for more information.
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UNDERSTANDING LEAD
Attend the session online or in-person to learn about lead and how to protect children.
Date: September 19, 2023
Time: 6:00PM-7:30PM
Location: Pueblo Department of
Public Health and
Environment (PDPHE)
101 W. 9th Street
Pueblo, CO 81003
Room: 3rd Floor Conference Room
Refreshments will be served
In Person Registration visit HERE
Online Registration visit HERE
For more information, visit: epa.gov/lead/community-lead-awareness-sessions
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HEALTH FIRST COLORADO MEMBER RENEWAL PACKETS
As we have discussed in previous roundtables, the state of Colorado is returning to normal renewal processes for Health First Colorado members. Please encourage members to check their email, mail, and PEAK inbox for their renewal packets. Encourage members to fill out the renewal packet, sign the renewal packet and return the packet by the due date. HCI has flyers in both English and Spanish called #KeepCoCovered on our website. You can print out copies of this flyer to have in your lobby area. See https://www.healthcoloradorae.com/members/address-and-renewal-updates/
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MEMEBER ENGAGEMENT OPPORTUNITIES
HCI hosts a “getting started” webinar on the first Thursday of each month from 11:00 – noon. This is for members, family members, and health care professionals to help understand all of benefits available for members to engage in their health care. NHP also hosts Advance Directive seminars on the last Thursday of each month for members, families, and health care professionals. For these and other member engagement opportunities, please see: https://www.healthcoloradorae.com/news/calendar-events/
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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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PUBLIC HEALTH INFORMATION | |
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ACCOUTABLE CARE COLLABORATION: PHASE III
The mission of the Department of Health Care Policy & Financing is to improve health care equity, access, and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado. The ACC Phase III features are designed in support of achieving this mission.
To learn more about the areas of focus in ACC Phase III visit https://hcpf.colorado.gov/accphase3
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MEMBER CO-PAY REDUCTION
Most existing Health First Colorado (Colorado’s Medicaid program) member co-pays are being reduced to $0 in accordance with Senate Bill (SB) 23-222 and SB 23-214, effective July 1, 2023. This change will be effective for members eligible for Title XIX, the Alternative Benefits Plan (ABP) and the Old Age Pension (OAP) Health and Medical Care Program. Other special programs administered by the Colorado Department of Health Care Policy & Financing (the Department), such as the Child Health Plan Plus (CHP+), will continue to have co-pays as normal. HCPF Provider Bulletin B2300496
https://hcpf.colorado.gov/sites/hcpf/files/Provider%20News%20%26%20Resources%20-%20Issue%2071%20%2006-26-23.pdf page 2
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PROVIDER TRAININGS
Did you know that the Department of Health Care Policy and Financing (HCPF) hosts trainings on the following topics.
- Billing Training
- Business Intelligence and Data Management
- Disability Competent are
- Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
- Falls Screening and Risk Reduction
- Long-Term Services and Support
- Medicare
- Targeted Case-Management-Transition Coordination (TCM-TC) Services Training
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UPCOMING WEBINARS AND EVENTS | |
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CARELON 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 Carelon Behavioral Health Trainings webpage.
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