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What's New

Provider Enrollment Application Fee Amount for Calendar Year 2025

The Affordable Care Act (ACA) requires certain providers to remit an application fee. The Centers for Medicare & Medicaid Services (CMS) sets the fee annually. This fee is assessed at initial enrollment, revalidation and change of ownership, as required, and is assessed in full for each service location enrolled in Health First Colorado (Colorado’s Medicaid program). The Provider Enrollment Application Fee has been set at $730 for the 2025 calendar year, effective January 1, 2025. 

Contact the Provider Services Call Center with questions.

Claims Denials Begin January 1, 2025 for Past-Due Revalidations

Effective 1/1/25, claims for providers that have not completed revalidation by their due date will be denied. Providers who successfully revalidate may resubmit their claims.

New Provider Type: Lactation Support Services

Health First Colorado and Child Health Plan Plus (CHP+) are expanding access to lactation services for members. Lactation Support Services include training and counseling the breastfeeding (or lactating) member about breastfeeding and human lactation, and providing comprehensive, skilled care and evidence-based information for breastfeeding and human lactation from pre-conception to weaning. 

Provider enrollment and billing details can be found in the Lactation Support Services billing manual, available in the CMS 1500 section on the Billing Manuals web page.

Reminder to Update Address for Internal Revenue Service (IRS) Form 1099 in Provider Web Portal

Providers are encouraged to ensure the IRS 1099 form mailing address on file with Health First Colorado is accurate and current prior to January 2025. Providers may add, view or modify the IRS 1099 form mailing address through the Provider Maintenance option in the Provider Web Portal. A confirmation letter will be sent to all linked provider service locations when an update is completed. 

Note: The IRS 1099 form mailing address is linked to the associated tax ID. If multiple provider IDs share the same tax ID, and one provider changes the 1099 address, that address will change for all providers with that tax ID.

Visit the Provider Maintenance - Provider Web Portal Quick Guide web page and view Address Changes for instructions on how to update an address in the Provider Web Portal.

Non-Emergent Medical Transportation (NEMT)

All Non-Emergent Medical Transportation (NEMT) providers are reminded to obtain a valid credentialing certificate issued by Transdev (formerly IntelliRide). Follow the steps outlined in the Special Provider Bulletin - Non-Emergent Medical Transportation (NEMT) - Reference: B2400515.

Providers must then revalidate with Health First Colorado (Colorado's Medicaid program). Providers who have not revalidated by November 30, 2024, are having their claims suspended for payment effective December 1, 2024, until their revalidation is completed.

Provider Newsletters

2024

Provider News & Resources - 12-16-2024 Issue 107 - This newsletter contains information on Did You Know? Revalidation Spreadsheet; Enrollment Processing Timelines; Claims Denials Begin January 1, 2025 for Past-Due Revalidations; Reminder: Update Address for IRS Form 1099 in Provider Web Portal; Intermediate Billing Training; Non-Emergent Medical Transportation (NEMT) Providers Meeting; Revalidation Explanation of Benefits (EOB) and Requirements for Billing, Individual and OPR Providers; Feasibility Study - Coverage of Housing & Nutrition Services; Provider Enrollment Application Fee Amount for Calendar Year 2025; All Patient Refined–Diagnosis Related Group (APR-DRG) Version 40 Update; Health First Colorado and Child Health Plan Plus (CHP+) Will Expand to Cover Children and Pregnant People Regardless of Immigration Status; Recently Updated Billing Manuals and Fee Schedules; Known Issues: Inaccurate Portal Display for Speech Therapy Units; Inaccurate Rates in Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Manual

Provider News & Resources - 11-25-2024 Issue 106 - This newsletter contains information on Did You Know? Verifying Member Eligibility; Upcoming Webinar: Medicaid Coverage Housing and Nutrition Services Feasibility Study; Vision Providers: Ordering, Prescribing and Referring (OPR) Claim Identifier Mandate; Recently Updated Billing Manuals and Fee Schedules; Known Issues: Physician Services/Clinics: Incorrect Rate on Fee Schedule for Procedure Code 20680; Speech Therapy: Inaccurate Portal Display for Speech Therapy Units; Resolved Known Issues: Ambulatory Care Services, Hospital-General and Physician Services/Clinics: Claims with Certain Procedure Codes Were Paying Incorrect Rates; All Providers: Some Professional Claims and Professional Crossovers Were Paid at an Incorrect Rate

Provider News & Resources - 11-20-2024 Issue 105 - This newsletter contains information on Did You Know? EOB 3110 - Claims Will Not Deny for Individual Not Being Linked to the Group; Upcoming Webinar: Perinatal SUD Community Conversation; Upcoming Webinar: Medicaid Coverage Housing and Nutrition Services Feasibility Study; Potential American Rescue Plan Act (ARPA) HCBS Direct Provider Payment; Recently Updated Billing Manuals and Fee Schedules; Known Issues: Hospice: Rate Update Effective October 11, 2024 (FFY 24-25); Clinic Practitioners, Hospitals - General and Ambulatory Surgery Centers: Claims with Certain Procedure Codes Are Paying Incorrect Rates; Resolved Known Issues: Clinic Practitioners: Claims with Procedure Code 59025 Were Paying Incorrect Rates When Billed with Modifier TC or 26; Clinics and Pediatric Behavioral Therapy: Providers Billing for Pediatric Behavioral Therapy; Featured Resources: Billing Manuals.

Provider News & Resources - 11-04-2024 Issue 104 - This newsletter contains information on Did You Know? Claim Detail Line Limitations; NEMT Providers: Featured NEMT Resources; Clinic Practitioners (PT 16) and SUD Clinics (PT 64): NEMT Information; Doing Business As (DBA) Name Field in the Provider Web Portal; Hospice Providers: Rate Update Effective October 11, 2024 (FFY 24-25); Updated Billing Manuals and Fee Schedules: Appendix R – Remittance Advice (RA) Messages; Pharmacist Services Billing Manual; Health First Colorado Fee Schedule July 2024; Immunization Fee Schedule; Known Issues: Clinic Practitioners (Provider Type 16): Claims with Certain Procedure Codes Are Paying Incorrect Rates; Resolved Known Issues; Featured Resources: November 2024 Provider Bulletin (B2400516); Special Provider Bulletin - Non-Emergent Medical Transportation (NEMT) (B2400515).

Provider News & Resources - 10-21-2024  Issue 103 - This newsletter contains information on Billing for Medicare Advantage Plans; Vision Providers: New EOB Code 5812; National Lead Poisoning Prevention Week: 10/20-10/26; Adult Long-Term Home Health (LTHH); Prescriber Tool Alternative Payment Model (APM) Stakeholder Meetings; Perinatal Substance Use Disorder (SUD) Community Conversation; Updated Billing Manuals and Fee Schedules; Immunization Providers: Resolved Known Issue: Some Claims Denying EOB 1178 or 7800; Clinic Practitioners (PT 16): Resolved Known Issue: Claims for Procedure Code J3301 Denying EOB 7827; Resolved Known Issue: Knee Arthroscopy/Surgery Procedure Code 29877 Paying Incorrect Amount; Behavioral Health Providers: Resolved Known Issue: Some Claims for Behavioral Health Services with Procedure Codes 90791 and 90792 Denying EOB 3981.

Provider News & Resources - 10-14-2024  Issue 102 - This newsletter contains information on Did You Know? Keep Licenses Current; Provider Web Portal Address Panel Changes; NEMT Providers: Revalidation Date Extension; Immunizations; Updated Billing Manuals and Fee Schedules; Known Issue: Short-Term Behavioral Health Service Information and Speech Therapy Units Unavailable in Provider Web Portal; Clinic Practitioners: Known Issue: Claims for Procedure Code J3301 Denying EOB 7827; Known Issue: Knee Arthroscopy/Surgery Procedure Code 29877 Paying Incorrect Amount; Resolved Known Issue: ASC Correction Rate Schedule; Clinic Practitioners: Resolved Known Issue: Some Claims for Procedure Code 83986 Denying EOB 7827.

Provider News & Resources - 09-30-2024  Issue 101 - This newsletter contains information on NEMT Providers: Moratorium on New Enrollments; NEMT Providers: Revalidation Reminder; Updated Billing Manuals and Fee Schedules; Resolved Known Issue: Health First Colorado Fee Schedule; Known Issue: ASC Correction Rate Schedule; Known Issue: Short-Term Behavioral Health Services and Speech Therapy Units Unavailable in Portal.

Provider News & Resources - 09-23-2024  Issue 100 - This newsletter contains information on Provider Enrollment: License Reminder; NEMT Providers: Revalidation Date; Clinic Providers: New SUD Features; All Medication Prescribers: Prescriber Tool APM Stakeholder Meetings; Providers Required to Collect EVV: Proper Use of POS 99; Providers Utilizing EVV: IP Address Change; Reminder: Sign Up for Provider Email Communications; Updated Billing Manuals and Fee Schedules; Resolved Known Issue: Health First Colorado Fee Schedule; Pediatric Behavioral Therapy Providers: Resolved Known Issue: Behavioral Therapy Reimbursements Discrepancy on Fee Schedule.

Provider News & Resources - 09-09-2024  Issue 99 - This newsletter contains information on Did You Know? Backdate Requests; NEMT Providers: Provider Credentialing Program; Pharmacy Providers: Reminder Update Fax Numbers; Updated Billing Manuals and Fee Schedules; Behavioral Health Providers Known Issue: Some Claims Denying EOB 2029; Resolved Known Issue: Health First Colorado Fee Schedule; CHRP Providers Resolved Known Issue: Some Claims with Procedure Code H2021 Denying EOB 3530.

Provider News & Resources - 08-19-2024  Issue 98 - This newsletter contains information on Pediatric Behavioral Therapy; Ordering, Prescribing and Referring Reminder; NEMT Providers: Revalidating Enrollment with Health First Colorado; PT, OT and ST Providers: Audit Limit Details Available During Eligibility Verification; Immunization Providers: COVID-19 Rates; Home and Community-Based Services; Intensive Behavioral Health Services Delivery Model; Date of Death Claim Adjustments; Featured Resource: New Provider Enrollment Training; Updated Billing Manuals and Fee Schedules; Resolved Known Issue: Health First Colorado Fee Schedule.

Provider News & Resources - 08-05-2024  Issue 97 - This newsletter contains information on Did You Know? Verifying Member Eligibility; Inpatient and Outpatient Hospital Providers: July 2024 Rate Updates; All Providers: Paper Claims; Physician Services: Bariatric Surgery Rule Change Consideration Meeting for Providers; NEMT Providers: Revalidating Enrollment with Health First Colorado; Featured Resource: Provider Web Portal Quick Guides; Updated Billing Manuals and Fee Schedules; Known Issue: Health First Colorado Fee Schedule; Resolved Known Issue: Correction Rate Schedule (ASC).

Provider News & Resources - 07-22-2024  Issue 96 - This newsletter contains information on Did You Know? What's New; Featured Quick Guide: Web Portal Registration; All Providers: Navigating the Provider Services Call Center IVR System; All Providers: Revalidation Reminder; Provider Enrollment Training; Correction: Durable Medical Equipment (DME) Manual Pricing; Physician Services: Bariatric Surgery Rule Change Consideration Meeting for Providers; Remote Monitoring for Outpatient Clinical Services Stakeholder Meetings; Updated Billing Manuals and Fee Schedules.

Provider News & Resources - Revalidation Special Newsletter - 06-17-2024 - This newsletter contains information on CMS Federal Mandate; Provider Notifications; Other Change Applications During Revalidation; Recently Asked Questions & Answers; Did You Know? Supplemental Questions Panel; Featured Resources.

Provider News & Resources - 06-10-2024  Issue 95 - This newsletter contains information on Did You Know? Revalidation; Updated Billing Manuals; Verify Member Eligibility; PRTF and QRTP Service Providers: Residential Provider Survey; Reminder: Sign Up for Provider Email Communications; DME Providers: Resolved Known Issue: Professional Claims for DME Wheelchair Repair Services Denying EOB 1997; Hospital Providers: Resolved Known Issue: Institutional Claims with Diagnosis Codes F840, F842, F845 Denying EOB 2029.

Provider News & Resources - 05-24-2024  Issue 94 - This newsletter contains information on License Update Requirement; HCBS Providers: New Denver County and Transportation Codes; HCBS Providers: Member Eligibility Benefit Plan Updates; Updated Billing Manuals; DME Providers: Resolved Known Issue: Professional Claims for DME Wheelchair Repair Services Denying EOB 1997; Hospital Providers: Resolved Known Issue: Institutional Claims with Diagnosis Codes F840, F842, F845 Denying EOB 2029; Audiology and Speech Therapy Providers: Resolved Known Issue: Speech Therapy Claims Denying EOB 0192, 1599 and 4211.

Provider News & Resources - 05-20-2024  Issue 93 - This newsletter contains information on Reminder: Group and Provider Affiliation Updates Required Every Six (6) Months; Did You Know? Revalidation Federal Mandate; System Error for Attachments in the Provider Web Portal; Pediatric Behavioral Therapy Providers: May 2024 Billing Training; Vision Providers: New Coverage of Corneal Crosslinking; Physician Services, Women’s Health: Information Regarding Hepatitis B Infection in Newborns; Featured Resource: Verifying Member Eligibility and Co-Pay; Updated Billing Manuals and Fee Schedules.

Provider News & Resources - 05-03-2024  Issue 92 - This newsletter contains information on Did You Know? Referring National Provider Identifier (NPI); Provider Disenrollment Due to Missing Revalidation; Direct Care Workforce Stabilization Board Public Hearings; Featured Quick Guide: Submitting an Institutional Claim Quick Guide; Updated Billing Manuals; Resolved Known Issue: Speech Therapy Claims Denying EOB 5551.

Provider News & Resources - 04-22-2024  Issue 91 - This newsletter contains information on Did You Know? Provider Disenrollment Due to Missing Revalidation; HCBS Program Aid Code Changes for Member Eligibility; Immunization Providers: Code 90611 Now a Covered Benefit; Reminder: STI Laboratory Testing is a Covered Benefit; LTSS Provider Webinar Announcement; Public Health Order – Syphilis Testing During Pregnancy; HCBS: Direct Care Workforce Stabilization Board Public Hearings; Updated Billing Manuals; Known Issue: Some Speech Therapy Claims for Evaluation Services are Denying for EOB 5551; Resolved Known Issue:  Some BHS Claims with SC Modifier Denying for EOB 2029; Resolved Known Issue: Some PT/OT Claims Denying for EOB 2305; Featured Resource: April 2024 Provider Bulletin (B2400507)

Provider News & Resources - 04-08-2024  Issue 90 - This newsletter contains information on Did You Know? Claim Submissions; PAD Providers: Quarter 2 Rate Update 2024; Updated Billing Manuals; NEMT Enrollments Continue to be Closed; Public Meeting to Gauge Community Interest in Potential Application to Federal Transforming Maternal Health (TMaH) Model; HCBS Program Aid Code Changes for Member Eligibility; LTSS Provider Webinar Announcement; HCBS: Direct Care Workforce Stabilization Board Public Hearings; Featured Resource: Revalidation FAQ; Known Issue: Some PT/OT Claims Denying for EOB 2305; Resolved Known Issue: Some Claims Billed by Optical Outlets Denying EOB 1997; Resolved Known Issue: Some Claims for PAD Denying EOB 7827.

Provider News & Resources - 03-25-2024  Issue 89 - This newsletter contains information on Did You Know? License Update Requirement; Moratorium on New Enrollments for NEMT; OPR: Enrollment Requirement; PAR Process When Health First Colorado is the Secondary Payer; HCBS: Benefit Plan Extension; Featured Resource: Revalidation FAQ; Reminder: Update Fax Numbers; Updated Billing Manuals; Resolved Known Issue: Professional Claims for DME Services Denying EOB 3530; Resolved Known Issue: Professional Claims for DME Services Denying EOB 7827; Resolved Known Issue: Institutional Claims Denying EOB 0192.

Provider News & Resources - 03-11-2024  Issue 88 - This newsletter contains information on Did You Know? Claim Submission Methods; Optum Change Healthcare (CHC) Cyber Security Issue; OPR Providers Required on Claims; Featured Resource: Revalidation FAQ; Updated Billing Manuals; Ambulatory Surgical Center Payment Methodology - Virtual Meetings; Known Issue: Behavioral Health Services Claims with SC Modifier Are Denying Incorrectly for EOB 2029; Resolved Know Issue: Claims for HCPCS 2024 PAD Procedure Codes Suspending EOB 0000.

Provider News & Resources - 03-04-2024  Issue 87 - This newsletter contains information on Did You Know? Enrollment Processing Time; Some Claims for HCPCS 2024 PAD Procedure Codes Suspending EOB 0000; Inpatient Hospital Base Rates Fiscal Year (FY) 23-24 Update; Supplemental Rate Increases; PAD Providers: Record Keeping and Retention; Updated Billing Manuals and Fee Schedules.

Provider News & Resources - Special Newsletter - Durable Medical Equipment (DME) Known Issues - 03-04-2024 - This newsletter contains information on Known Issue: Some Professional Claims with Durable Medical Equipment (DME) E2599, K0108 and T5999 Procedure Codes Denying for Explanation of Benefits (EOB) 7827; Resolved Known Issue: Resolved 02/27/24: Some Professional Claims for Durable Medical Equipment (DME) Services for Procedure Code A4287 Denying for Explanation of Benefits (EOB) 0192; Resolved 02/24/24: Some Professional Claims for Durable Medical Equipment (DME) Services for Procedure Code E0955 with Modifier NU Suspending for Explanation of Benefits (EOB) 2861.

Provider News & Resources - 02-26-2024  Issue 86 - This newsletter contains information on Doula Survey; Updated Billing Manuals; Claims for HCPCS 2024 Procedure Codes were Suspending EOB 0000; Updates to Network Participation/Affiliations Available During Revalidation; PT/OT Providers: Satisfaction Survey; Pharmacy: Prescriber Tool Alternative Payment Model; HCBS LTSS Providers: Provisional Provider Payment; ColoradoPAR Program; Featured Resource: Revalidation FAQ; Sign Up for Provider Email Communications; Known Issue: Institutional Claims Denying EOB 0192.

Provider News & Resources - 02-05-2024  Issue 85 - This newsletter contains information on Did You Know? 2024 HCPCS Updates; Revalidation Requirements for Billing Providers; OPR: Enrollment Requirement; NEMT: Claim Attachment Requirements; NEMT: IntelliRide Reminder; Behavioral Health Stakeholder Webinar; Updated Billing Manuals; Known Issue: Professional Claims for DME Services Denying EOB 2861; Resolved Known Issue: Professional Claims for DME Services Suspending EOB 1512; Resolved Known Issue: Claims for Physical Therapy and Occupational Therapy Denying EOB 4211.

Provider News & Resources - 01-15-2024  Issue 84 - This newsletter contains information on HCBS: Career Resources for Direct Care Workers; 2024 Medicare Part A and Part B Deductible Amounts; 2024 Provider Enrollment Application Fee; BHA Coverage Type Not Eligible for Medicaid or CHP+; Requirements for Eyewear Providers; Updated Billing Manuals; Resolved Known Issue: Some Speech Therapy Claims were Denying for EOB 5550, 5551 and 5552.

Provider News & Resources - 01-08-2024  Issue 83 - This newsletter contains information on Did You Know? License Update Requirement; 2024 Provider Enrollment Application Fee; Claims for HCPCS 2024 Procedure Codes Suspending for EOB 0000; New System Error for Attachments in the Provider Web Portal; New Language Proficiency Field Available for Providers; HCBS: Money Follows the Person (MFP) Capacity Building Grant; Incorrect Speech Therapy (ST) Sessions in Provider Web Portal and Incorrect ST Denials; Immunization Rate Update; Pharmacist-Administered Vaccines; NOVAVAX COVID-19 Vaccines; Immunization Updates and Reminders; Updated Billing Manuals; Resolved Known Issue: Some Claims for Speech Therapy are Denying for EOB 5550, 5551 and 5552.

2023

Provider News & Resources - Issue 82  12-11-2023 - This newsletter contains information on Provider Stakeholder Opportunity - Serving Justice-Impacted Members; Claims for HCPCS 2024 Procedure Codes Suspending for EOB 0000; Incorrect Speech Therapy (ST) Sessions in Provider Web Portal and Incorrect ST Denials; Updated Billing Manuals; Known Issue: Some Claims for Speech Therapy are Denying for EOB 5550, 5551 and 5552; Resolved Claims with DME Procedure Codes E2599, K0108 and T5999 Denying EOB 7577; Resolved Known Issue: Professional Claims with Procedure Code S0190 with a G7 Modifier Denying EOB 7802.

Provider News & Resources - Issue 81  12-04-2023 - This newsletter contains information on Did You Know? Third Party Liability (TPL); Updated Billing Manuals; Verifying Medicaid Coverage - New Coverage Types: New Coverage Type Not Eligible for Medicaid or Child Health Plan Plus (CHP+); Resolved Known Issue: Claims for Speech Therapy Denying for Non-Physician Practitioner Group Providers; Resolved Known Issue: Claims with DME Procedure Codes E2599, K0108 and T5999 Denying EOB 7577; Resolved Known Issue: Professional Claims with Procedure Code V5267 Denying EOB 7827; Resolved Known Issue: Professional Claims with Procedure Code S0190 with a G7 Modifier Denying EOB 7802.

Provider News & Resources - Issue 80  11-27-2023 - This newsletter contains information on Provider Enrollment Application Fee Amount for Calendar Year 2024; Provider Enrollment Revalidation; Updated HCBS Rate Schedules; Reminder: Update Fax Numbers; Updated Billing Manuals; Known Issue: Claims for Speech Therapy Denying for Non-Physician Practitioner Group Providers; Known Issue: Claims with DME Procedure Codes E2599, K0108 and T5999 Denying EOB 7577; Known Issue: Professional Claims with Procedure Code V5267 Denying EOB 7827; Known Issue: Professional Claims with Procedure Code S0190 with a G7 Modifier Denying EOB 7802.

Provider News & Resources - Issue 79  11-13-2023 - This newsletter contains information on Did You Know? Provider Enrollment Revalidation; HCBS: Career Resources for Direct Care Workers; Provider Enrollment Revalidation; Reminder: Submission Request for Paper Claims; COVID-19 Public Health Emergency (PHE) Unwind; Coverage of RSV Vaccine; Delegate Provider Web Portal Accounts; Behavioral Health Administration (BHA) Benefits (BHAB); OPR Upcoming Enrollment Requirement; Sign Up for Provider Email Communications; Updated Billing Manuals; Resolved Known Issue: Maternity Claims Denying EOB 1087 and EOB 1088.

Provider News & Resources - Issue 78  10-16-2023 - This newsletter contains information on Provider Enrollment Reminder; Provider Resources for Outages; Moratorium on New Enrollments for NEMT; Did You Know? Member Eligibility; Direct Care Worker Survey; Immunization Providers: Vaccine Code Updates; Pediatric Behavioral Therapies, Outpatient Speech Therapy, Occupational Therapy and Physical Therapy Co-Treatment; Updated Billing Manuals and Fee Schedules; Resolved 10/04/23: Updated COVID Vaccine Codes.

Provider News & Resources - Revalidation Special Newsletter - 09-29-2023 - This newsletter contains information on Did You Know? Revalidation Spreadsheet; Provider Enrollment Revalidation; Accessing the Provider Web Portal; Featured Resources.

Provider News & Resources - Issue 77  09-22-2023 - This newsletter contains information on Rate Change for Providers Conducting Psychological or Neuropsychological Testing; Timely Filing Resubmission Instructions; Speech Therapy Session Information; Training Grants Available for Direct Care Workers; Updated COVID Vaccine Codes; Updated Billing Manuals; Featured Quick Guide: Verifying Member Eligibility and Co-Pay.

Provider News & Resources - Issue 76  09-11-2023 - This newsletter contains information on Did You Know? Third-Party Liability; Verifying Member Eligibility; Fee Schedules; DORA License Providers: License Portal Panel Field Changes and License Reminder; Lower of Pricing Logic for Rate Increases; HCBS Providers: Provider Training Grants Available; SUD Providers: Third Annual Substance Use Disorder Stakeholder Forum; Updated Billing Manuals; Known Issue: Claim Processing Times for New Procedure Codes; Resolved 08/16/23: Outpatient Hospital Claims Paying Incorrect Rate.

Provider News & Resources - Issue 75  08-18-2023 - This newsletter contains information on Did You Know? Keeping a Claim in Timely Filing; Certification Panel Changes in the Provider Web Portal; PAD Providers: Prior Authorization (PA) Requirements; Family Planning Access in Colorado; Written Appeals Process; Updated Billing Manuals; Resolved Known Issue: Vaccine Claims with Procedure Code 0113A Denying EOB 3280; Resolved Known Issue: Outpatient Hospital Claims Paying Incorrect Rate.

Provider News & Resources - Issue 74  08-07-23 - This newsletter contains information on Did You Know? New Virtual Agent Option for Case Managers; Updated Billing Manuals; Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services; Reminder: Update Fax Numbers; Resolved Known Issue: COVID Booster Claims Using Procedure Code 0174 Denying for EOB 3261; Resolved Known Issue: Prevention of Duplicate Injectables within Seven Days of Billing.

Provider News & Resources - Issue 73  07-20-23 - This newsletter contains information on Did You Know? Electronic Claims Requirement; Reminder: Signatures on Paper Claims; Updated Billing Manuals; Sign Up for Provider Email Communications; Resolved Known Issue: EBD Claims for Procedure Code S5170 Denying for EOB 1544 and EOB 4758; Resolved Known Issue: Prevention of Duplicate Injectables within Seven Days of Billing; Resolved Known Issue: PDN Claims Denying Incorrectly for EOB 5548.

Provider News & Resources - Special Newsletter - Durable Medical Equipment (DME) Known Issues - 07-14-2023 - This newsletter contains information on Resolved Known Issue 07/07/23: Claims for DME Denying for EOB 4070 or EOB 2861.

Provider News & Resources - Issue 72  07-10-23 - This newsletter contains information on Did You Know?  Timely Filing; New Portal to Support the FAMLI Program; Member Co-Pay Reductions; COVID-19 Vaccine CPT Codes; Prevention of Duplicate Injectables within Seven Days of Billing; Updated Billing Manuals; Resolved Known Issue: NPI Error with Revalidation Applications; Resolved Known Issue: PETI PAR Error Message.

Provider News & Resources - Special Newsletter - Durable Medical Equipment (DME) Known Issues - 07-07-2023 - This newsletter contains information on Resolved Known Issues: Resolved 07/07/23: Claims for DME Denying for EOB 4070 or EOB 2861; Resolved 05/04/23: Some DME Supply Claims Paying at Incorrect Rate; Resolved 04/07/23: DME Supply Claims Paying at Incorrect Rate.

Provider News & Resources - Issue 71  06-26-23 - This newsletter contains information on ARPA 4.02 Promoting Single Occupancy Grant; Member Co-Pay Reductions; eConsult Platform Informational Update; Member ID Card Phone Numbers; Updated Billing Manuals and Fee Schedules; Known Issue: NPI Error with Revalidation Applications; Resolved Known Issue: PAD Claims Paid or Denying due to HCPCS/NDC Crosswalk File; Resolved Known Issue: DME Supply Claims Suspending EOB 3530.

Provider News & Resources - Special Newsletter - Durable Medical Equipment (DME) Known Issues - 06-19-2023 - This newsletter contains information on Known Issue: DME Supply Claims Suspending EOB 3530; Resolved Known Issues: Resolved 06/09/23: DME Supply Claims Suspending EOB 2861; Resolved 05/19/23: DME Supply Claims Suspending EOB 2861; Resolved 05/04/23: Some DME Supply Claims Paying at Incorrect Rate; Resolved 04/26/23: DME Supply Claims Paying at Incorrect Rate; Resolved 04/07/23: DME Supply Claims Paying at Incorrect Rate.

Provider News & Resources - Issue 70 06-12-2023 - This newsletter contains information Did You Know? Enrollment Requirements; Health First Colorado Enrollment; NPI Updates in the Provider Web Portal; New COVID-19 Vaccine CPT Codes; Multi-Payer Portal Values; Updated Billing Manuals; Known Issue: DME Supply Claims Suspending EOB 286; Resolved Known Issue: Claims Suspending EOB 7900; Resolved Known Issue: Hospital and PAD Claims Paid or Denying due to HCPCS/NDC Crosswalk File; Resolved Known Issue: Claims for Immunizations Denying EOB 7803; Resolved Known Issue: Adult Home Health Denying for PA; Resolved Known Issue: DME Supply Claims Suspending EOB 2861.

Special Newsletter - Public Health Emergency (PHE) Unwind Resources - 05-22-2023 - This newsletter contains information on Scammer Alert; The COVID-19 Public Health Emergency (PHE); Provider Revalidations; Resources and How to Stay Informed

Provider News & Resources - Issue 69 05-05-2023 - This newsletter contains information on Provider Communication Resources; Provider Revalidation Timelines; Care and Case Management (CCM) System; Member ID Card Phone Numbers; Updated Billing Manuals; Known Issue: Trading Partners and/or Submitters: Batch Files; Resolved Known Issue: Claims for Adult Home Health Services Denying for Prior Authorization; Resolved Known Issue: Hospital Inpatient Claims Denying EOB 2303; Resolved Known Issue: DME Supply Claims Paying at Incorrect Rate.

Provider News & Resources - Issue 68  05-01-2023 - This newsletter contains information on Did You Know? Verifying Member Eligibility; Public Health Emergency (PHE) Unwind Resources; Updated Billing Manuals; Known Issue: DME Supply Claims Suspending EOB 2861; Resolved Known Issue: DME Supply Claims Paying at Incorrect Rate; Resolved Known Issue: Adult Long Term Home Health Claims Denying for PA.

Provider News & Resources - Issue 67  04-14-2023 - This newsletter contains information on ICN and Region Codes Guide; Updated Billing Manuals; Integrated Behavioral Health Care Grant Application; Nursing Facilities and Assisted Living Residences: FAQ Document; Featured Quick Guide:  Verifying Member Eligibility; Known Issue: Adult Long Term Home Health Claims Denying for PA; Resolved Known Issue: Home Health Claims Denying for EOB 4761; Resolved Known Issue:  Home Health PDN Claims Denying for EOB 1331; Resolved Known Issue: Outpatient Speech, Physical, and Occupational Therapy Claims Denying for EOB 3054; Resolved Known Issue: Dental Rate Updates for New HCPCS Effective January 1, 2023.

Provider News & Resources - Issue 66  04/10/2023 - This newsletter contains information on Did You Know? Provider Web Portal URL; Reminder: New Diagnosis or Procedure Codes; Enrollment License Requirements and License Panel Updates; Opioid Treatment Providers: Take-Home Buprenorphine; Critical Incident Reporting for Residential Providers; Updated Billing Manuals; Known Issue: Hospital Inpatient Claims Denying EOB 2303; Known Issue: Home Health Claims Denying for EOB 1331; Known Issue: Some Durable Medical Equipment (DME) Supply Claims Paying at Incorrect Rate; Resolved Known Issue: Dental Rate Updates for New HCPCS Effective January 1, 2023; Resolved Known Issue:  Home Health PDN Claims Denying EOB 1331; Resolved Known Issue: DME Supply Claims Paying at Incorrect Rate.

Provider News & Resources - Issue 65  03-20-23 - This newsletter contains information on Public Health Emergency (PHE) Ending May 11, 2023; Revalidation Reminder; New Provider Web Portal URL: Claims Processing and Provider Services Call Center Unavailable Friday, March 24, 2023; Kepro® - ColoradoPAR Annual Provider Satisfaction Survey; Dental Rate Updates for New HCPCS Effective January 1, 2023; Integrated Behavioral Health Care Grant Application Opens March 22, 2023; Prior Authorization Requests with Private Duty Nursing Services; Updated Billing Manuals; Resolved Known Issue: Claims Denying for Invalid Prior Authorization (PA).

Provider News & Resources - Issue 64 03-13-23 - This newsletter contains information on Timely Filing Guidelines; 2022-2023 RSV Season and Synagis® Vaccine Benefit; Kepro® - ColoradoPAR Provider Satisfaction Survey; New Provider Web Portal URL; Enrollments Requiring Affiliated Practitioners; Reminder: Known Issues and Provider Resources Web Pages; Featured Resource: Virtual Agent Routing Tips; Updated Billing Manuals and Fee Schedules; Sign Up for Provider Email; Resolved Known Issue: Claims Denying for Invalid Prior Authorization; Resolved Known Issue: Claims for HCPCS 2023 Procedure Codes Suspending for EOB 0000.

Provider News & Resources - Issue 63 02-16-23 - This newsletter contains information on Early Closure: Provider Services Call Center; Holiday Closure: Presidents Day; Update: COVID-19 Monoclonal Antibody Injection Evusheld; PAD HCPCS Verify Benefit Coverage; Featured Resource: General Provider Information Manual; Updated Billing Manuals; Known Issue: Claims for HCPCS 2023 Procedure Codes Suspending for EOB 0000.

Provider News & Resources - Issue 62 02-03-2023 - This newsletter contains information on Authenticating When Contacting the Provider Services Call Center; Did You Know? Known Issues and Provider Resources; New PPA Effective March 1, 2023; HCBS Providers: Stakeholder Opportunities Feedback Sessions and Surveys; Featured Quick Guides and Resources: Interpreting Claim Numbers; Pharmacy Providers: Update Fax Numbers; Updated Billing Manuals; Resolved Known Issue:  NEMT Claims with Procedure Codes and Modifier 76 Denying EOB 7817; Resolved Known Issue:  NEMT Claims with Procedure Code A0427 and Modifier 76 Denying EOB 7817.

Provider News & Resources - Issue 61 01-16-2023 - This newsletter contains information on Authenticating When Contacting the Provider Services Call Center; Enrollment Processing Timelines; Revalidation Reminder; PHE Extension; Reminder: Verify Primary Insurance Coverage; Updated Billing Manuals; Known Issue: COVID-19 Vaccine Claims with Procedure Codes 0044A and 90471 Denying EOB 7809 and/or EOB 1381; Resolved Known Issue: HCBS: IHSS Claims for H0038 with the U5 Modifier Paid at Incorrect Rate.

Provider News & Resources - Issue 60 01-09-2023 - This newsletter contains information on Authenticating When Contacting the Provider Services Call Center; COVID-19 Pediatric Bivalent Boosters;  Hospital Providers: Inpatient Hospital Review Program Survey;  Flu Vaccine Code Configuration Correction; Recently Updated Billing Manuals;  Known Issue: Transportation Claims With Procedure Codes and Modifier 76 Are Denying for EOB 7817;  Known Issue: Transportation Claims With Procedure Code A0427 and Modifier 76 Are Denying for EOB 7817 Known Issue: Claims for HCPCS 2023 Procedure Codes Suspending for EOB 0000;  Resolved Known Issue: HCBS Providers: IHSS Claims for H0038.