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Provider Maintenance

Last updated: 10/31/2024
 

Table of Contents

 

Get Started

Log in to the Provider Web Portal and click Provider Maintenance.

provider maintenance link on homepage

 

Click Provider Maintenance again.

provider maintenance link

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Submit an Update

Follow these instructions after any update has been made.

Click Go to Submit at the bottom of the page to open the Attachments and Fees section.
 

Click submit
Add any required attachments.

add attachments

 

Check the I accept box, enter the name of the person reporting the change, and click the Submit button.


accept and submit

 

Retain the tracking number to check the status of the request.

tracking number

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Add a Specialty

Click Specialty and Contact Information Changes on the left navigation panel to add a new specialty.

Screenshot of Specialty and Contact Information panel.

 

Click [+] next to Click to add specialty to access the drop-down menu.

Screenshot of Specialty and Contact Information panel for adding a specialty.

 

Select the specialty from the Specialty drop-down list.

Screenshot of Specialty and Contact Information panel for adding a specialty in drop-down list.

 

Add the effective and end dates. A unique taxonomy is usually required for each specialty.

Taxonomies are not necessary for provider types that do not require a National Provider Identifier (NPI). Some Home and Community-Based Services (HCBS) providers may enter a taxonomy. Options will display in the Taxonomy drop-down list, if available.

Screenshot of Specialties section.
 

Options will not display if they are not required.

Taxonomies will not display

 

Click either Add to add the specialty or Reset to clear the information.

Screenshot of adding a specialty.

 

Confirm that the new specialty appears in the list.

Screenshot of Specialties section - confirmation

Multiple unique specialties may be added. 

Note: At least one taxonomy must be on file for the provider record that matches any of the taxonomies listed in the National Plan & Provider Enumeration System (NPPES) NPI Registry.

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Address Changes

Update Address

Click Address Changes on the left navigation pane, and then click [+] next to the address being changed.

Provider address panel showing expanded checkboxes.

 

Edit the information and click Save.

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Update Phone or Fax Number

Phone and fax numbers may be updated in Address Changes in the left navigation pane.

Click [+] next to the address type. Multiple phone numbers and fax numbers may be added. An office phone number is required for each address.

Edit the phone numbers and click Save.

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Provider Directory Changes

Provider directory changes may be completed only in the Service Location address.

Provider address panel showing opt out provider directory

 

Edit the address information, if necessary, check or uncheck the applicable boxes, and click Save.

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Update Doing Business As (DBA) Name

Click Provider Identification Changes on the left navigation pane.

proMain-DBAname-01-10312024.png (618×144)

Facility, Atypical, and Group providers may view and update the DBA name in the optional Doing Business As field.

proMain-DBAname-02-10312024.png (611×185)

Billing Individual (BI) providers may view and update the DBA name in the optional Doing Business As field.

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Update Bed Counts (Assisted Care Facilities, Hospitals and Substance Use Disorder Facilities)

Click Other Information Changes on the left navigation pane.

Other Information panel

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Assisted Care Facilities

Assisted Care Facility providers may enter new bed information in the Institutional Bed Information panel. The Effective Date and End Date fields must be completed for the information to be valid.

Update the information in the bed number fields to reflect the provider’s current license.

Complete all fields in the skilled bed row or all fields in the Intermediate Care Facility (ICF) bed row as applicable to the provider.

Institutional Bed Information

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Hospitals

Hospital providers may enter new inpatient bed information in the Institutional Bed Information panel. All fields must be completed for the information to be valid.

Hospital Institutional Bed Information

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Substance Use Disorder (SUD) Facilities

Substance Use Disorder (SUD) Facilities providers may update the number of beds available at the service location for bed types of Facility Residential or Facility Residential Withdrawal. The options displayed in the Bed Type drop-down list are determined by the provider’s active specialties. SUD providers must edit the End Date of the existing bed number before adding a new bed number. Only one (1) active record is allowed per bed type.

There must be at least one active SUD bed record before proceeding with the provider maintenance request. If an SUD bed record with a Bed Type of Historical is displayed, active records for bed types of Facility Residential and Facility Residential Withdrawal must be entered. The Historical record displays SUD bed information prior to the bed types being separated in the application.

Scroll to the row displaying 12/31/2299 in the End Date field to update an existing bed number.

Click [+] at the left to expand the row.

Enter the end date for the current count and click the Save button.

proMain-SUD-Bed-Info-01-09192024.png (763×736)

 

Click [+] next to Click to add Substance Use Disorder Beds to expand the row.

Complete the information to add a new bed number, if needed. 

Click Reset to erase the content in all fields.

Verify that all data is correct and click Add.

Note: The effective date of the new bed count cannot start on or before the end date of the previous entry.

proMain-SUD-Bed-Info-02-09192024.png (761×723)

 

Result: A new row is added to the grid.

proMain-SUD-Bed-Info-03-09192024.png (763×640)

 

Note: Some SUD Continuum specialties do not allow SUD bed records to be entered. The SUD bed records for those specialties will have the Number of SUD Beds set to zero (0) for both bed types and cannot be changed.

proMain-SUD-Bed-Info-04-09192024.png (624×419)

 

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 Update Malpractice or Liability Insurance

Click Other Information Changes on the left navigation pane.

Providers must maintain an up-to-date record of a malpractice or liability insurance policy with Health First Colorado (Colorado’s Medicaid program). Providers may update and submit the most recent insurance information using the Insurance panel.

Fill in the blanks and click Add.

required fields for Malpractice and General Liability Insurance

 

Most providers are not required to submit a copy of the insurance documentation. Exceptions to this include Provider Types 20-Nursing Facility and 21-Nursing Facility-ICF/IID.

Click Attachments and Submit on the left navigation pane once the information is entered.

Attach the supporting documentation, complete required fields, and click Submit.

Note: Users with the Fingerprint Panel are always directed to the Fingerprint Panel before being allowed to go to the Attachments and Submit panel.

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Additional Options for Provider Search

Health First Colorado members using the Health First Colorado Find a Doctor web page now have greater search options due to the Additional Provider Search Options section in the Provider Web Portal. The section contains five (5) optional subsections:

  • Community Association: All providers may specify any community associations.
  • Cultural Competency: All providers may specify any cultural competencies.
  • Preferred Name: All providers may specify a preferred name that is different than the legal or Doing Business As (DBA) name.

Note: The following subsections are visible for Long-Term Services and Supports (LTSS) providers only.

  • Alternate Provider Addresses: LTSS providers may specify up to three (3) alternate phone numbers and addresses.
  • Servicing Counties: LTSS providers may specify the counties in which they serve for each enrolled specialty.

Screenshot of Additional Provider Search Options section.

 

Community Association

All providers may identify specific community associations and add as many as needed. This information is searchable on the Health First Colorado Find a Doctor web page.

Click the Add button after a Community Association is selected. The screen updates and adds the selected item. Add as many Community Association records as needed. Click the Remove link to remove a record.

Screenshot of Community Association section

 

Cultural Competency

All providers may identify specific cultural competencies and add as many as needed. This information is searchable on the Health First Colorado Find a Doctor web page.

Click the Add button after a Cultural Competency is selected. The screen updates and adds the selected item. Add as many Cultural Competency records as needed. Click the Remove link to remove a record.

Screenshot of Cultural Competency section.

 

Preferred Name

All providers may specify a preferred name different than the legal name or Doing Business As (DBA) name. The Preferred Name should be the name by which the community knows the entity. This information is searchable on the Health First Colorado Find a Doctor web page.

Screenshot of Preferred Name section.

 

Alternate Provider Addresses

Long-Term Services and Supports (LTSS) providers may enter up to three (3) alternate addresses different than the service location, mailing and billing addresses entered on the Addresses panel. This information is searchable on the Health First Colorado Find a Doctor web page.

Click the Add button after an address record is populated. The screen updates and adds the address. Up to three (3) addresses may be added. Click the Remove link to remove a record. 

Complete address information, a primary email and an office phone must be entered to add an address.

Screenshot of Alternate Provider Addresses section.

Screenshot of Alternate Provider Addresses section - blank new record.

 

Servicing Counties

Long-Term Services and Supports (LTSS) providers may identify the specific counties served for any of the enrolled specialties. All specialties may be selected in the Specialty drop-down list if the provider has more than one (1) specialty. A record is added for each specialty and Servicing County. This information is searchable on the Health First Colorado Find a Doctor web page.

Click the Add button after a record is populated. The screen updates and adds the record. Duplicate records are not allowed. Click the Remove link to remove a record.

Screenshot of Servicing Counties section.

Screenshot of Servicing Counties section - multiple entries.

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Affiliations

Click Group or Provider Affiliation Changes on the left navigation pane to add a group/business affiliation to an individual’s enrollment.

Click [+] next to Click to add Group Affiliation.

Screenshot of the Provider Maintenance Group Affiliation panel in the Provider Web Portal

 

Click the magnifying glass to search for a group/business.

screenshot of the Click to add Group affiliation with the magnifying glass circled.

 

Search for the group/business by National Provider Identifier (NPI), Health First Colorado Provider ID, Name or Organization.

search button

 

Click the Provider ID for the group/business and ensure it is the correct location.

Click provider ID

 

Select the effective date for the affiliation and click Add.

Choose effective date for affiliation

 

Continue to add group/business affiliations as needed.

additional group and business affiliations

 

Click the Add tab to add an individual affiliation to a group’s/business’s enrollment.

Enter the provider’s NPI. If unknown, click the magnifying glass to search for the provider by name or organization. 

magnifying glass circled when adding individual affiliation

 

Search results will show providers’ effective dates of enrollment with Health First Colorado.

Note: All providers listed on a claim must be enrolled with Health First Colorado.

Click the correct Provider ID, enter the affiliation Effective Date, and click Save

Ending Affiliations

Complete the End Date of the affiliation and click Save to end an affiliation. The process is the same for both individuals and groups/businesses.

adding end date to remove affiliation

 

Check the box to confirm affiliations have been reviewed. 

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Update Disclosure Names

Effective May 2021, the name field on the Disclosure A and Disclosure D panels of the Provider Web Portal was updated to allow an Organization Name and an Individual Name to be entered separately. Existing providers must review and update the Disclosures panel during the next Provider Maintenance request or as part of the Revalidation application.

Providers performing a Provider Maintenance update will see the following error on the Attachments and Submit panel upon clicking Submit if the Disclosure panel needs to be updated.
 

DisclosureError-01102024_0.jpg (731×329)

 

Click Disclosure Changes on the left navigation pane to resolve the error. Disclosures requiring an update will display a Pending status.

Pending Disclosure

 

Select a pending disclosure. The current information on record will be reflected in the applicable field(s). Update the Organization Name and/or First Name, Middle Initial (MI) and Last Name, then click Add.

close up screenshot of the organization name fields

 

Disclosure B

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Check the Status of an Update Request

Click the Provider Maintenance Status link.

provider maintenance status link

Enter the Tracking Number for the update request and click Search.

enter tracking number

View Status details.

status

 

Need More Help?

Visit the Quick Guides web page to find all the Provider Web Portal Quick Guides.