Table of Contents
- Renewing, Adding, Updating or Removing a License
- Renewing a License
- Adding a License
- Updating a License
- Removing a License
- Certification
- Clinical Laboratory Improvement Amendments (CLIA) Certification
Provider Maintenance is where a provider will update their information, including license updates.
- Login to Provider Web Portal.
- Click Provider Maintenance.
- Click Provider Maintenance again.
- Click the Provider Identification Changes page.
Note: Providers must select at least one payer. Providers will be required to view and electronically sign a Provider Participation Agreement (PPA) specific to each payer selected.
Renewing, Adding, Updating or Removing a License
Providers can renew an active license with the same license number, add a new license with a different number, select an earlier expiration date of an existing license or remove a license that is not yet submitted.
If the license is a Colorado Department of Regulatory Agencies (DORA), an automatic lookup will be performed when the Issuing Authority and License # are entered. If a match is found in DORA, the Effective Date, Expiration Date and Issuing State will be retrieved and populated automatically.
Renewing a License
Providers can renew a license when the license number is the same as an existing active license record and there is a new effective/expiration date span. To renew a license, expand the drop-down that reads "Click to add new license or renew existing license".
Select the license record to be renewed from the license record drop-down. Once the license record is selected, information will be prepopulated. The Effective Date, Expiration Date, and Type fields can be edited.
Note: Effective and expiration dates cannot overlap with an existing record for the same license number.
Providers requiring a primary license type must indicate a license type as Primary. Providers not requiring a primary license may indicate a license type as Secondary. The expiration date may be changed to an earlier date than what is displayed. The license expiration date cannot be set past the currently approved Expiration Date.
Note: When a Primary license is required all spans should indicate Active and remain as Active even when the license has expired, for claims to process.
Click "Add" when done.
Adding a License
To add a new license that has a different number, expand the drop-down that reads "Click to add new license or renew existing license" or "+".
Input information in the license area for all required fields and the optional field as appropriate.
Click "Add" when done.
Updating a License
Providers can update an existing license record to indicate an earlier expiration date.
Click the "+" option beside the active license number to expand. Input information in all fields as required. The description is an optional text field. The Issuing State and Issuing Authority are required dropdown fields.
Providers requiring a primary license type must indicate a license type as Primary. Providers not requiring a primary license may indicate a license type as Secondary. The expiration date may be changed to an earlier date than what is displayed. The license expiration date cannot be set past the currently approved Expiration Date.
Click "Save" when done.
Inactive records are read-only.
Removing a License
To remove a license, select the license number from the existing record. Click "Remove" to remove the entire row. Only newly added licenses can be removed.
Certification
A Certification can be added or changed through the "Provider Maintenance: Provider Identification" page. A copy of the Certification is required as an attachment in order to process the request.
Note: Some existing Certification records might have a Certification Type that is no longer valid and the field will be displayed as blank. Review each Certification record and select a new Certification Type, if applicable.
Clinical Laboratory Improvement Amendments (CLIA) Certification
A CLIA Certification can be added or changed through the "Provider Maintenance: Provider Identification" page. A copy of the CLIA certificate is required as an attachment in order to process the request.
When viewing an existing CLIA Certification on the "Provider Identification" page, do not be concerned if the "Effective Date" displayed does not match the "Effective Date" originally entered or the date of the most recent certification. The Effective and End Dates for all CLIA licenses are as follows:
Effective Date:1/1/1900
End Date: 12/31/2299
When adding or changing a license, a copy of the license must be submitted on the "Provider Maintenance: Attachments and Submit" page. Attach a license under the "Attachments" section and enter data for all required fields. Press "Add" to add the attachment to the grid.
Under the "Submit" section, click the "I accept" checkbox and enter the name of the person reporting the change. Click "Submit". An auto-generated tracking number will be generated.
- Retain the tracking number.
- Check the status of an update request.
- Click the "Provider Maintenance Status" link.
- Enter the "Tracking Number" for the update request and click "Search".
- View the status details under the "Provider Maintenance - Summary" section.
- Click the "Provider Maintenance Status" link.
Need More Help?
Visit the Quick Guides web page to find all the Provider Web Portal Quick Guides.