Delegates - Access Definitions

Users are only able to delegate only the functions they have. The user does not have access to a function if that function does not appear in the list.

1. Care Management - Submit Resubmit Authorization
   Allows access to create an authorization and view, edit or add providers on the Maintain Favorite Providers page.
2. Care Management - View Authorization
   Allows access to search for and view authorizations.
3. Claim - Inquiry
   Allows access to search for and view dental, institutional and professional claims.
4. Claim - Submit and Resubmit
   Allows access to submit, resubmit, copy and void dental, institutional and professional claims.
5. Electronic Health Record (EHR) Incentive Payment Program
   Allows access to the EHR Incentive Payment Program.
6. Files Exchange (Electronic Data Interchange [EDI])
   Allows access to the File Upload and Download pages where X12 files can be uploaded or downloaded.
7. Member Focused Viewing
   Allows access to the Member Focused Viewing page, which provides high-level information about eligibility, claims and authorizations, and should be given only to those delegates who also have access to eligibility, claims and authorizations.
8. Provider Maintenance
   Allows access to update data originally submitted during provider enrollment.
9. Resources - Download Reports
   Allows access to the Report Download page under the Resources tab, permitting delegates to download Call Tracking Management System (CTMS) letters, Remittance Advice (RA) reports and other non-X12 letters and reports.
10. Resources - Search HIPAA Error Codes
    Allows access to the Search Health Insurance Portability and Accountability Act (HIPAA) Error Codes page, permitting delegates to search for additional information on Claim Adjustment Reason Codes (CARCs) and Remittance Advice Reason Codes (RARCs).
11. Revalidation
    Allows access to the Revalidation process that providers must perform at least once every five (5) years per Centers for Medicare & Medicaid Services (CMS). Note: The provider's Revalidation link is available only during the Revalidation period. If delegated, it would be available to the delegate only during the Revalidation period.
12. Search Accounts Receivable
    Allows access to the Search Accounts Receivable page where users can search for and pay Accounts Receivables (ARs).
13. Search Alerts
    Allows access to the Search Alerts page, permitting delegates to view alerts from the Colorado interChange for a variety of things (e.g., prior authorizations, claims).
14. Search Payment History
    Allows access to the Search Payment History page, permitting delegates to search for payments, view claims associated to payments and download PDF and delimited versions of Remittance Advices (RAs).
15. Secure Correspondence
    Allows access to the Secure Correspondence page, permitting delegates to view, submit or reply to secure correspondence messages.
16. Verify Eligibility
    Allows access to the Verify Eligibility page, permitting delegates to:
    • Verify coverage information for a member, including co-pay amounts.
    • Verify limit information, both dollar and unit limits, for a member.
    • Verify managed care assignment information for a member.
    • Verify lock-in details for a member.
    • Verify plan of care details for a member, including patient liability.
    • Verify Early and Periodic Screening, Diagnostic and Treatment (EPSDT) details for a member.
    • View other insurance information, including Medicare Parts A and B.
    • Add other insurance information.

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