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Appendix I

Note: All providers with a current Health First Colorado Provider ID number, or those providers submitting an application to become a Health First Colorado Provider MUST REVIEW AND ACCEPT the Provider Participation Agreement as part of the Online Enrollment process.

PROVIDER PARTICIPATION AGREEMENT

The current Provider Participation Agreement (PPA) is located on the Department’s Provider Forms web page under the Provider Enrollment & Update Forms drop-down menu.

Appendix I Revisions Log

Revision Date Appendix Made by
12/01/2016 Updated for New Fiscal Agent HPE (now Gainwell)
1/10/2017 Updates based on Colorado iC Stage II Provider Billing Manual Comment Log v0_3.xlsx HPE (Now Gainwell)
1/19/2017 Updates based on Colorado iC Stage II Provider Billing Manual Comment Log v0_4.xlsx HPE (Now Gainwell)
1/26/2017 Updates based on Department 1/20/2017 approval email HPE (now Gainwell)
5/22/2017 Updates based on Fiscal Agent name change from HPE to DXC Gainwell
5/27/2022 Updated PPA link and Provider Enrollment web page Link HCPF
6/8/2022 Converted PDF to web page HCPF