Colorado interChange: Resources for your Membership
Week of January 29, 2018
As the Colorado interChange moves toward normal operations, we'll be broadening the focus of this newsletter to bring you hot topics and useful information on a larger variety of issues related to Health First Colorado (Colorado's Medicaid Program) and other initiatives from the Department of Health Care Policy & Financing (the Department). We'll continue to focus on issues we believe your members we be discussing and resources to share. 
Provider Buzz
Here's a look at hot topics for providers and others:
  • Providers are reminded to verify coverage under Benefit Details (example shown here) on the Provider Web Portal before rendering services. The Alternative Benefit Plan (ABP) is an extended plan which must be accompanied by Medicaid State Plan (TXIX) coverage. If the member does not have TXIX coverage, they are not eligible for services and claims will be denied for EOB 3261 - "The procedure code currently is not a benefit for date of service billed. Refer to the CPT or the HCPCS listing for valid procedure codes." For detailed, step-by-step instructions on verifying member eligibility, refer to the Verifying Member Eligibility - Provider Web Portal Quick Guide, available under the Quick Guides section on the interChange Resources web page.
  • For Tax Year 2017 providers may receive two 1099 Miscellaneous Income (1099-MISC) forms from the State of Colorado due to implementation of the Colorado interChange in March 2017. Specifically, if a provider was enrolled in Colorado Medicaid for the period January - February 2017, they will receive a 1099-MISC form from the State of Colorado, Office of the State Controller. Providers enrolled in Colorado Medicaid for the period March - December 2017, will receive a 1099-MISC form from the Department of Health Care Policy and Financing. The amounts shown on the 1099's are what the Department has reported to the IRS.

Other hot topics from the Department
News You Can Use
Here's some content for membership newsletters:

New Fee Schedules and instructions available now

An updated and downloadable versions of the July 2017 Fee Schedule Data File (1/18) and the July 2017 Fee Schedule Instructions (1/18) have been posted to the Provider Rates & Fee Schedule web page, under the Health First Colorado Fee Schedule drop-down section.


  Updated information includes downloadable data files for all updated fees. 
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