Ensuring Full Continuum SUD Benefits - Managed Care Entities
Managed Care Entities
The Accountable Care Collaborative has four Managed Care Entities (MCEs), four Regional Accountable Entities (RAEs), and one Managed Care Organization (MCO). They are responsible for providing oversight of SUD services covered under the behavioral health capitation. The MCEs contract with providers to deliver services to members, manage the authorization processes and process payments provided under the capitation. MCEs contract with providers to offer behavioral heath services (Including SUD services) to members, within their geographic area whenever possible and with providers in other parts of the state when there are not available providers enrolled with Health First Colorado in the region. For certain specialty types of care such as Youth Residential Services and Special Connections (services for pregnant and postpartum individuals) the number of providers in the state is small and RAEs may be contracted for services with providers outside of their region.
Regional Accountable Entities
Learn more about the RAEs contracted with the Department to serve Health First Colorado members, what areas each one covers and links to their websites.
| Region | Organization Information |
|---|---|
| 1 | Rocky Mountain Health Plans (RMHP) and RMHP PRIME
|
| 2 | Northeast Health Partners (NHP)
|
| 3 | Colorado Community Health Alliance (CCHA)
|
| 4 | Colorado Access (COA)
|
| MCO | Elevate (Denver Health) Medicaid Choice
|
Locating SUD Providers
In addition to the SUD Provider Network Map, a printer-friendly version of the SUD Provider Network is also available in list format.
MCE Resources
- State Behavioral Health Services Billing Manual
- Colorado SUD Standard Authorization Request Form
- Standard RAE Provider Forms
- Accountable Care Collaborative Care Phase III