HCI Behavioral Health Provider Newsletter
A monthly collection of must-know information and resources
| |
|
In this issue:
Provider Resources and Information
- August is Back to School Month
- 988 Suicide & Crisis Lifeline
- One Colorado Resources for Providers
- Reminder to Verify Provider License Status
- Transition for Ending Reimbursement for Residential Child Care Facilities
- Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
- Colorado Medicaid Program Provider Rate Adjustments
- Billing Under A Licensed Behavioral Health Clinician
- Update to Uniform Services Coding Standards (USCS) Manual
- Incorrect Health First Colorado Member Billing
- Home and Community Based Services for Persons With Intellectual and/or Developmental Disabilities Waiver Programs
- UPDATED Behavioral Health Outpatient Authorizations
- Behavioral Health Claims and Billing Information
- ICYMI: RAE Roundtable Behavioral Health Resources
- Behavioral Health Provider Handbook
COVID
- Stay Updated on the Public Health Emergency Declaration
- FREE COVID Self Tests
- Statewide COVID Vaccine Information
Upcoming Webinars / Events
| |
PROVIDER RESOURCES AND INFORMATION | | |
|
|
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.
| |
|
988 SUICIDE & CRISIS LIFELINE
988: The easy-to-remember, three-digit dialing, texting, and chat code for anyone experiencing a suicidal or mental health related crisis or emotional distress. The Substance Abuse and Mental Health Services Administration (SAMHSA) developed a 988 Partner Toolkit to equip the field with key messages, answers to frequently asked questions, branding guidelines, etc.
| |
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.
| |
|
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.
| |
|
TRANSITION FOR ENDING REIMBURSEMENT FOR RESIDENTIAL CHILD CARE FACILITIES
From the Department of Health Care Policy & Financing
The Department outlined the end of reimbursement for residential child care facilities (RCCF) via Policy Transmittal (RAE MCO 22-02) in May 2022. That policy transmittal indicates that the Capitated Behavioral Health Benefit managed by Managed Care Entities (MCEs) will no longer reimburse Residential Child Care Facilities (RCCFs) who are enrolled as Provider Type (PT) 52 effective July 1, 2022. See the entire document here.
| |
|
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. Click here for more detailed information.
| |
|
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.
| |
|
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.
| |
|
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
Health Colorado, Inc. (HCI and 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. HCI 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 HCI website.
| |
|
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 HCI webpage where you can access the Zoom recording and slides.
| |
|
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 PROVIDER HANDBOOK
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.
| |
|
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. You are also encouraged to visit the state site as well.
| |
|
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.
| |
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.
| |
|
RAE ROUNDTABLE FOR BEHAVIORAL HEALTH PROVIDERS---2nd Friday of every month at 11am
Please click here to join the webinar:
Or By Telephone:1-669-900-6833---Webinar ID: 995 7438 8100----Passcode: 173943
Visit the HCI 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.
| |
|
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.
| | | | | |
