In this issue:

• COVID-19
• COVID-19 Therapeutics Program for Health Care Providers
• FREE COVID-19 Self Tests
• Stay Up To Date With the Public Health Emergency Declarations
• Colorado COVID-19 Health Care Provider Vaccine Information Toolkit
• Statewide COVID-19 Vaccine Information
• Provider Resources and Information
• August is Back to School Month
• National Immunization Awareness Month
• Reminder to Verify Provider License Status
• Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
• New National Maternal Mental Health Hotline
• One Colorado Resources for Providers
• Colorado Medicaid Provider Rate Adjustments
• Billing Under a Licensed Behavioral Health Clinician
• Update to Uniform Services Coding Standards (USCS) Manual
• Incorrect Health First Colorado Member Billing
• Diabetes Study Patient Recruitment
• Home and Community Based Services for Persons with Intellectual and/or Developmental Disabilities Waiver Programs
• UPDATED Behavioral Health Outpatient Authorizations
• ICYMI: RAE Roundtable Behavioral Health Resources
• Behavioral Health Claims and Billing Information
• Provider Handbooks
• Care Coordination and Behavioral Health Providers Fact Sheet
• Upcoming Events and Webinars
• Member Resources

COVID-19 THERAPEUTICS PROGRAM FOR HEALTH CARE PROVIDERS

In an ongoing effort to decrease hospitalizations for at-risk Coloradans by ensuring access to COVID-19 therapeutics, we are sharing information provided by the Colorado Department of Public Health and Environment (CDPHE) for health care providers. Included here is updated National Institutes of Health (NIH) recommendations, as well as provider eligibility and enrollment information for both the CDPHE Therapeutics program and Health and Human Services (HHS) Test to Treat program, Health care providers are encouraged to learn more about these lifesaving treatments and talk about them with patients who may be eligible to receive them.

FREE COVID-19 SELF TESTS

Residential households in the U.S. are now eligible for another order of free COVID-19 self- tests on USPS.com.

• Each order now includes 8 rapid antigen COVID-19 tests
• Orders will come in 2 separate packages (4 tests in each package), each with its own tracking number and will ship for free

Self- tests for COVID-19 give rapid results and can be taken anywhere, regardless of your vaccination status or whether or not you have symptoms. They give your result in a few minutes and are different from laboratory-based tests that may take days to return your result. 

STAY UPDATED WITH THE PUBLIC HEALTH EMERGENCY DECLARATIONS

Another extension started July 15, 2022, and if extended the full 90 days, runs through October 13, 2022.

Keep updated on the public health emergency declarations for COVID-19 by visiting this site.

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.

STATEWIDE COVID-19 VACCINE INFORMATION

Colorado Department of Public Health and Environment provides extensive resources and up to date information regarding the COVID-19 vaccine. 

• Colorado Vaccine Providers Listed by County
• Mobile Vaccination Clinics
• Transportation to Vaccine Sites
• COVID-19 Vaccine FAQs
• Learn About COVID-19 Vaccines
• Vaccine Data Dashboard
• For vaccine information from the Colorado Department of Public Health and Environment, visit this webpage.

AUGUST IS BACK TO SCHOOL MONTH

It's school time again! Going back to school comes with stress and anxiety for kids and they may need extra support as they head back to the classroom. Below are several resources to help parents, teachers, caregivers and students navigate this challenging time and focus on overall mental well-being.

• NHP Back to School Checklist
• National Institute of Mental Health-Shareables on Child and Adolescent Mental Health
• National Alliance on Mental Illness-Kids, Teens and Young Adult Resources
• CDC-Back to School Helping Students Thrive
• CDC-Youth Mental Health

NATIONAL IMMUNIZATION AWARENESS MONTH

August is National Immunization Awareness Month which highlights the efforts to protect patients of all ages against vaccine-preventable diseases through on-time vaccinations. Below you will find links to resources that will assist you in communicating this annual observance with your patients and provide you with tools as well.

• NHP Immunization/Vaccination Tip Sheet
• CDC Toolkits and Resources Encouraging Vaccinations
• Immunize Colorado
• Colorado Immunization Resources

REMINDER TO VERIFY PROVIDER LICENSE STATUS

A Message From The Colorado Department of Health Care Policy & Financing

Providers are reminded to keep licenses up to date. If a provider has recently received a notification about an expired license, the status can be confirmed by logging into the Provider Web Portal to verify the license status and update licenses as applicable.

1. Login into the Provider Web Portal. Note: Delegates have limited access, check with your administrator if your access allows updating capabilities for licensing. 
2. Select Provider Maintenance, twice.
3. Click on Provider Identification Changes.
4. Result: All applicable licenses that are on file and associated with the portal account will display.

Refer to the Provider Maintenance - Update License Quick Guide for more information.

EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT (EPSDT)

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides free, comprehensive and preventive health care services for children and youth ages 20 and under including adults who are pregnant, who are enrolled in Medicaid. EPSDT is key to ensuring that children and youth receive appropriate preventive, dental, mental health, developmental and specialty services. More information can be found at the links below.

• Colorado Department of Healthcare Policy & Financing EPSDT
• NHP EPSDT Tip Sheet

NEW NATIONAL MATERNAL MENTAL HEALTH HOTLINE

The new National Maternal Mental Health Hotline provides 24/7, free, confidential support, resources and referrals to any pregnant and postpartum mothers facing mental health challenges and their loved ones. The service is available via phone and text in English or Spanish.

Call or text, 1-833-9-HELP4MOMS (1-833-943-5746) to connect with counselors at the National Maternal Mental Health Hotline.

Pregnancy and a new baby can bring a range of emotions. In fact, many women feel overwhelmed, sad, or anxious at different times during their pregnancy and even after the baby is born. For many women, these feelings go away on their own. But for some women, these emotions are more serious and may stay for months. The National Maternal Mental Health Hotline’s counselors provide real-time emotional support, encouragement, information, and referrals. Pregnant and postpartum women can get the help and resources they need, when they need it. For more information, visit this webpage.

ONE COLORADO RESOURCES FOR PROVIDERS

One Colorado is the state’s leading advocacy organization dedicated to advancing equality for lesbian, gay, bisexual, transgender, and queer (LGBTQ) Coloradans and their families. They effectively advocate for LGBTQ Coloradans and their families by lobbying the General Assembly, the executive branch, and local governments on issues like safe schools, transgender equality, relationship recognition, and LGBTQ health and human services. This link offers guidance and resources to improve care provision, create more inclusive and welcoming spaces, and opportunities for further training and education as providers.

COLORADO MEDICAID PROGRAM PROVIDER RATE ADJUSTMENTS

Health First Colorado (Colorado’s Medicaid program) across-the-board provider rate increases were approved by the Joint Budget Committee during the 2022 legislative session and are effective for dates of service beginning July 1, 2022, pending State Plan Amendment (SPA) approval from the Centers for Medicare and Medicaid Services (CMS) prior to implementation. The fee schedules located on the Provider Rates & Fee Schedule web page have been updated to reflect the 2.0% across-the-board rate increases. Rates will be updated in the Colorado interChange for dates of service beginning July 1, 2022. Any category of service or subset of individual services within a category receiving a targeted rate increase mentioned in other bulletin articles are not eligible for the across-the-board increase. 

Contact Victoria Martinez at Victoria.L.Martinez@state.co.us with questions or concerns. 

BILLING UNDER A LICENSED BEHAVIORAL HEALTH CLINICIAN

Effective May 1, 2022, language was provided to allow newly licensed behavioral health providers to continue to bill under a supervisor (licensed behavioral health clinician) while pursuing contracting with a Regional Accountable Entity (RAE). This is being expanded to allow newly hired licensed behavioral health providers with a group practice to bill under a supervising behavioral health clinician while the provider is working toward credentialing and contracting with a RAE.

Effective July 1, 2022, this policy understanding will be reflected in the Uniform Service Coding Standards Manual with the following language:

Practitioners who are enrolled with Medicaid and have applied for credentials with a Regional Accountable Entity (RAE) may submit claims under a supervising provider for a maximum of 90 days while completing contracting with a RAE.

This policy applies to:

• Newly licensed BH providers who were providing services to members under clinical supervision while they were working toward licensure.
• Licensed BH providers who are hired by a group practice.

Contact John Laukkanen at John.Laukkanen@state.co.us with questions about this policy.

UPDATE TO UNIFORM SERVICES CODING STANDARDS (USCS) MANUAL

Effective July 1, 2022, a new edition of the USCS Manual contains significant formatting and content updates. Providers are strongly encouraged to review the guidance pages and appendices in this manual for new information. The USCS Manual can be found on the Accountable Care Collaborative Phase II Provider and Stakeholder Resource Center web page. Contact hcpf_bhcoding@state.co.us with questions related to this manual.

INCORRECT HEALTH FIRST COLORADO MEMBER BILLING

From Colorado Department of Health Care Policy & Financing

Health First Colorado members cannot be billed for services covered by Health First Colorado.

Providers cannot bill members in the following circumstances:

Third-Party Liability (TPL) co-pays and deductibles – Providers cannot bill members

for the difference between commercial health insurance payments and the billed

charges when Health First Colorado does not make additional payment. The provider

also cannot bill members for co-pay or deductibles assessed by Third-Party Liability

(TPL) (commercial insurance). Refer to the General Provider Information Manual for more

information.

Delayed Notification of Eligibility from the member - Providers must verify eligibility

within a timely manner.

Claim denials - Timely filing, place of service invalid, contract invalid, or other

denials for the line item or the entire claim are not valid reasons to bill the member.

Provider is not enrolled with Health First Colorado - Once the services have been

rendered to the member, the provider must enroll with Health First Colorado in order

to receive payment. The provider may not bill the member if they choose to not

enroll.

Providers shall not send overdue Health First Colorado member accounts to collection

agencies unless the billing is for a non-covered service and the member has reneged on a

written payment agreement.

Visit the Policy Statement: Billing Health First Colorado Members for Services web page for more information.

DIABETES STUDY PATIENT RECRUITMENT

A diabetes study is being conducted by Tamara Oser, MD and Sean Oser, MD, MPH of the Department of Family Medicine University of Colorado Anschutz Medical Campus. Your patients may qualify if they:

• Are over 18 years of age
• Have been diagnosed with type 1 diabetes
• Have an interest in diabetes technology

Eligible participants are adults 18-89 years old with Type 1 Diabetes diagnosed at least 1 year ago, treated with injections (not an insulin pump). Study participation will consist of two 14-day periods as outpatients, virtually or in-person. 

Please review this flyer. If providers need more information or have questions, please reach out to either:

Sean Oser sean.oser@cuanschutz.edu  717-552-6333 

Tamara Oser tamara.oser@cuanschutz.edu  717-552-6334

HOME AND COMMUNITY BASED SERVICES FOR PERSONS WITH INTELLECTUAL AND/OR DEVELOPMENTAL DISABILITIES WAIVER PROGRAMS

The Home and Community Based Services (HCBS) waiver programs provide Health First Colorado members who meet special eligibility criteria access to additional services in their homes and communities as an alternative to institutional care. Level of care determinations are made annually by the case management agencies (aka Community Centered Boards). Members must meet financial and medical eligibility, as well as program-specific criteria to access services under a waiver. The applicant must be at risk of transition to a nursing facility, hospital, or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). To utilize waiver benefits, members must be willing to receive services in their homes or communities. For more information, click here to be taken to the Department of Health Care Policy and Financing's webpage regarding this program.

UPDATED BEHAVIORAL HEALTH OUTPATIENT AUTHORIZATIONS

Northeast Health Partners (Regional Accountable Entity) is contracted with the Colorado Department of Health Care Policy and Financing (HCPF) to manage Health First Colorado behavioral health benefits through the Colorado Community Behavioral Health Services Program. NHP is contracted with Beacon Health Options and has delegated oversight of utilization management programs to Beacon. HCPF will continue to manage and pay for physical health benefits. HCPF will handle appeals for a Notice of Adverse Benefit Determination related to any physical health denial.

Outpatient services which are considered "routine" do not require prior authorization. Those include the following codes: 0510, 0513, 90791, 90792, 90832, 90834, 90837, 90839, 90846, 90847, 90849, 90853, 96372, H0001, H0002, H0004, H0005, H0006, H0018, H0020, H0023, H0025, H0031-34, H0036-38, H2000, H2014-18, H2021, H2022, H2027, H2030, H2031, S9445, S9453, S9454, T1017, T1023 and all E&M codes. 

• Medication Assisted Treatment (MAT) no authorization (for in-network providers)
• Intensive Outpatient Program (IOP) needs authorization

This information can be found in the Behavioral Health Provider Handbook located on the NHP website.

IN CASE YOU MISSED IT: RAE ROUNDTABLE BEHAVIORAL HEALTH RESOURCES

Here is a link to information that was offered in previous Beacon RAE Roundtables, including the July call information on Colorado Medicaid Eligibility and Application Process, Medicaid Benefits, Access to Care Standards, Payment Standards and ASAM Levels.

BEHAVIORAL HEALTH CLAIMS AND BILLING INFORMATION

Beacon Colorado Provider Relations team previously hosted a training on behavioral health billing and claims. If you missed the training or need a refresh, please click here and it will take you to the NHP webpage where you can access the Zoom recording and slides.

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.

RAE ROUNDTABLE BEHAVIORAL HEALTH---2nd Fri of every month at 11am

Please join the Beacon Colorado Provider Relations team every month for relevant behavioral health trainings, resources, and discussion. 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.

CLAIM SUBMISSION GUIDELINES--WEBINAR

Hosted by Beacon Health Options

This live training provides an overview of billing and claims information and how to submit claims to Beacon Health Options along with reviewing best practices and avoiding claim denials.

• Wednesday, August 10, 2022  12pm (MST)
• Click here to register.

DIABETES AND HYPERTENSION CARE USING TELEHEALTH AND REMOTE MONITORING TECHNOLOGIES--WEBINAR

Hosted by ECHO Colorado In Partnership With Colorado Department of Public Health & Environment

The goal of this series is to provide updates and practical guidance on the use of telehealth tools and programming in diabetes, hypertension and high blood cholesterol management. The three-session series will provide practical information on incorporating remote patient monitoring (RPM) in your practice, including the use of continuous glucose monitors (CGM) and self-measured blood pressure (SMBP) monitoring. This series will also include components of telehealth policy and reimbursement, and how COVID-19 has impacted change in these areas. Learn from experts in the field on how to incorporate these tools into your practice in order to gain confidence and improve care for your patients.

• Three weekly ECHO sessions held virtually on Wednesdays 12pm - 1pm (MST) starting

            August 17, 2022

• Click here for more information and to sign up for the series.

PROVIDERCONNECT OVERVIEW--WEBINAR

Hosted by Beacon Health Options

This webinar is intended for providers and office staff becoming familiar with ProviderConnect, Beacon's provider portal, for the first time.

• Wednesday,  August 24, 2022   12pm (MST)
• Click here to register.

DUAL DIAGNOSIS: SUBSTANCE USE AND MENTAL HEALTH DISORDERS--WEBINAR

Hosted by Beacon Health Options

An introductory level training on Dual Diagnosis: the co-occurrence of substance use disorders and mental health disorders. This 1.5 hour course will cover definitions, statistics and warning signs of substance use and mental health disorders, as well as discuss potential causes and effects. It will also explore various treatment considerations including the importance of integrated screening and treatment. There is no CE credit or certification associated with this training.

• Wednesday, August 24, 2022  1pm (MST)
• Click here to register.

PROVIDERCONNECT AUTHORIZATIONS--WEBINAR

Hosted by Beacon Health Options

This webinar is designed for providers and office staff who submit authorizations through ProviderConnect, Beacon's provider portal.

• Wednesday, August 31, 2022   12pm (MST)
• Click here to register.

2022 ANNUAL BEHAVIORAL HEALTH TRAINING CONFERENCE

Colorado Behavioral Healthcare Council (CBHC) is hosting the largest Behavioral Health Conference in the state of Colorado. Each year, hundreds of behavioral health specialists, members of the state and criminal justice system, physical health providers, and university students attend CHBC’s annual behavioral health conference. The conference focuses on best clinical and business practices in behavioral health. They have a great lineup of presenters, including keynote speakers, Dr. Morgan Medlock and Daniel Lerner.

• September 21, 2022 through September 24, 2022
• Beaver Run Resort & Conference Center in Breckenridge, Colorado
• Click here for detailed information and to register.

HEALTH FIRST COLORADO: WHERE TO START--WEBINAR

Northeast Health Partners and Beacon will assist with questions new members have regarding Medicaid benefits.

• First Thursday of each month   11:00am - 11:30am (MST)
• Click here for the flyer and how to join.

August 5, 2022