In this issue:

• Department of Health Care Policy and Financing (HCPF)
• HCPF Data Security Incident
• Accountable Care Collaborative: Phase III
• Care and Case Management (CCM) System
• Provider Trainings
• Provider Resources and Information
• Provider Revalidation Timelines
• Understanding Lead
• 2-1-1 Get Connected Get Help
• DentaQuest Member Information
• Health First Colorado Member Renewal Packets
• Member Engagement Opportunities
• 2-1-1 GET CONNECTED GET HELP
• HCPF Provider Bulletin Index
• Member Complaint and Appeal Information for Providers
• Provider Handbooks
• Upcoming events and webinars

HCPF DATA SECURITY INCIDENT

Please be aware of a HCPF data security incident potentially involving Health First Colorado (Medicaid) and Child Health Plan Plus (CHP+) members’ personal information. The following memo outlines how to assist members if they have any questions related to this incident. Visit HCPF website for more information https://hcpf.colorado.gov/moveit

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

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. 

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

Please visit https://hcpf.colorado.gov/provider-trainingto for more information.

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.

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

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.

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. NHP 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.northeasthealthpartners.org/members/address-and-renewal-updates/.

MEMEBER ENGAGEMENT OPPORTUNITIES



NHP hosts a “getting started” webinar on the first Thursday of each month from 11:00 – 11:30 am. 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.northeasthealthpartners.org/news/calendar-events/. 

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.

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.

MEMBER COMPLAINT AND APPEAL INFORMATION FOR PROVIDERS 

Health First Colorado members have the right to file a complaint and/or appeal at any time. For information about this process, please review this information to assist members with questions. This information can also be located on the Northeast Health Partners' website.

PROVIDER HANDBOOKS

As a reminder, you can access both the primary care provider and behavioral health provider handbooks on Northeast Health Partners' website under the Provider Handbooks & Policies section. Please utilize these resources to answer questions in regards to member services, provider information, key performance indicators, etc.

For questions, please email coproviderrelations@carelon.com.

NORTHEAST HEALTH PARTNERS' WEBSITE

Northeast Health Partners' website provides many resources for members to access to keep up with their health and wellness. Please share this information as needed.

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.

RAE ROUNDTABLE ---2nd Friday of every month at 11am

ROUNDTABLES ARE AVAILABLE ON MICROSOFT TEAMS

PLEASE USE THE UPDATED LINK BELOW

All behavioral health and primary care medical providers are encouraged to attend! Please join the Carelon Colorado Provider Relations team every month for important updates, relevant trainings, resources, and discussion.

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Visit the NHP website for details on previous calls.

IN CASE YOU MISSED IT: RAE ROUNDTABLE RESOURCES

If you were unable to attend a previously hosted RAE Roundtable, please visit this Northeast Health Partners’ website for information.