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- When does the Revalidation Application need to be submitted?
- Are there specific instructions by specialty?
- What information can be changed when revalidating?
- Why can't some of the information on the revalidation application be changed?
- Can a revalidation application be submitted while a change application is in process?
- How does revalidation affect the financial cycle? When will payment be received?
- Are there EOB Reasons specific to revalidation?
- What is the expected timeline of revalidation activities once an application is submitted?
- Where can more information be found about revalidation?
When does the Revalidation Application need to be submitted?
The revalidation deadline is based on the date the enrollment application was approved.
Refer to the Provider Revalidation Dates Spreadsheet for a list of revalidation due dates by provider, provider type, provider ID, and NPI.
Each provider is notified by email six months in advance of their revalidation deadline. Providers are reminded to verify that their email addresses are correct to prevent notification delays.
Are there specific instructions by specialty?
Yes. Refer to the Provider Type Information for Revalidation web page to find specific instructions by provider type and specialties.
What information can be changed when revalidating?
Review the table titled "What information can be updated through revalidation?” on the Revalidation web page to review what information can be updated when revalidating. The most common information changes are licenses, disclosures, addresses and contacts.
Why can't some of the information on the revalidation application be changed?
Some information will be auto-populated on the application. Auto-populated information cannot be changed on the application and must be updated separately outside of the revalidation process by submitting a Provider Maintenance request. Review the table titled "What information can be updated through revalidation?” on the Revalidation web page to review what information can be updated when revalidating.
NOTE: Log in to the Provider Web Portal and click "Provider Maintenance” to start a Provider Maintenance request.
Can a revalidation application be submitted while a change application is in process?
No. Providers cannot submit a revalidation application while an active change application is in process.
Providers are reminded to prioritize their revalidation application process ahead of any other change applications to reduce delays. Providers may request that an active change application be cancelled by calling the Provider Services Call Center at 1-844-235-2387. After the cancellation is complete, providers may submit the revalidation application.
How does revalidation affect the financial cycle? When will payment be received?
Providers who revalidate before their revalidation due date should not experience any delays in payment. Providers who revalidate AFTER their revalidation due date will experience a delay in claims processing.
Claims are processed weekly on Fridays. Once a provider has an approved revalidation application, claims will be processed in the weekly financial cycle. Providers could receive payment the Thursday following that Friday financial cycle.
Are there EOB Reasons specific to revalidation?
Yes.
- EOB 7511 – Billing provider has not completed revalidation.
- EOB 7512 - Rendering/Performing provider due for revalidation.
- EOB 7513 - Attending provider has not completed revalidation.
- EOB 7514 - Ordering, Referring, Supervising provider due for revalidation.
Providers who have not completed revalidation before their due date may see an Explanation of Benefits (EOB) Reason shown above. Providers will be required to complete their revalidation before claims are processed.
What is the expected timeline of revalidation activities once an application is submitted?
The expected timeline is five (5) business days after a complete application is submitted. Revalidation approval may take longer than five (5) business days if the application is returned to the provider due to incorrect or incomplete information.
Where can more information be found about revalidation?
Refer to the Revalidation web page on the State of Colorado website.
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.