Revalidation

Health First Colorado and CHP+ Provider Revalidation

Child Health Plan Plus (CHP+) and Health First Colorado (Colorado's Medicaid program) providers must revalidate in the program at least every five (5) years to continue as a provider. Organization Health Care Providers are required to obtain and use a unique National Provider Identifier (NPI) for each service location and provider type enrolled.

Attention: Download the Provider Revalidation Dates Spreadsheet to verify the next revalidation due date. Providers will be contacted via email approximately six (6) months prior to their revalidation deadline with further instructions. Attempting to revalidate by completing a new application before being notified will create duplicate enrollments and cause claim processing issues.

Effective 01/01/2025, claims for providers that have not completed revalidation by their due date are being denied. Providers who successfully revalidate may resubmit their claims.

What can providers do now to prepare?

• Ensure each National Provider Identifier (NPI) for Health First Colorado is also enrolled with Medicare, for providers who bill Medicare.
• Obtain a new NPI prior to revalidating, if needed. House Bill 18-1282 requires newly enrolling and currently enrolled organization healthcare providers (not individuals) to obtain and use a unique NPI for each service location and provider type enrolled in the Colorado interChange.
• Ensure all data and contact information in each enrollment profile is correct prior to revalidation. Contact the Provider Services Call Center if the Provider Web Portal log-in credentials need to be reset for the provider to access the Provider Web Portal. Refer to the Provider Maintenance - Provider Web Portal Quick Guide located on the Quick Guides web page for step-by-step instructions on updating provider affiliations and contact information.
• Ensure that employees who have left a provider group no longer have Provider Web Portal access for information such as revalidation, claims, eligibility and banking updates. Providers must set the status to inactive for any delegates no longer in the group by logging into the Provider Web Portal, clicking on Manage Accounts, and clicking the Add New Delegate/Office Staff tab. Refer to the Delegates Provider Web Portal Quick Guide located on the Quick Guides web page for more information.

What do providers need to know?

• Review the Revalidation Resources and Revalidation Newsletters section box above for more information on the revalidation process.
• Refer to the Revalidation Quick Guide located on the Quick Guides web page for more information on completing the revalidation application through the Provider Web Portal.
• Providers will be revalidated on a continuous, rolling five (5)-year schedule.
• Providers with multiple locations will not have to revalidate all sites at once unless all the locations were approved at the same time. Email notices will be sent separately for each location.
• Each provider will be notified via email six (6) months in advance of their revalidation deadline. The deadline is based on the date the enrollment application was approved.

What information can be updated during revalidation?

The table below displays information that can be updated during the revalidation process in the Provider Web Portal versus what can be updated through a Provider Maintenance Request. 

During the revalidation process some information is auto-populated so not all sections are required. Providers should verify all information in the provider's enrollment profile is correct and up-to-date prior to revalidation.

Note: A check (✓) denotes data can be changed. An (X) denotes data cannot be changed.

* The column is not a conclusive list of all items that can be updated through a Provider Maintenance Request.