Dear Podiatry Providers,
Thank you for your continued partnership as the Colorado Medicaid program is moving to a more modern system that provides greater transparency and accuracy. These changes will ultimately increase the quality of services provided to our members and brings the program into compliance with federal program integrity and accountability standards.
The Department and DXC are aware of outstanding issues affecting DPMs, i.e. provider type (06). We understand this implementation has been frustrating at times and has had a negative impact on the financial stability and sustainability of some practices.
The following update affecting podiatry providers has been posted to the Department's Known Issues & Updates web page.
Non-EPSDT Services Denying for Clinics with CRNA or Podiatrist as Rendering Providers
Clinic claims for non-EPSDT services are incorrectly denying for EOB 0678 - "Billing Provider Type and Specialty is not allowable for the Rendering Provider" when a Certified Registered Nurse Anesthetist (CRNA) or a Podiatrist is listed as the rendering provider. Clinic providers are allowed to bill non-EPSDT services for these provider types.
A fix for this issue is scheduled to be implemented by the August 25, 2017 financial cycle.
Claims will be reprocessed by DXC.
Any provider experiencing financial hardship can call the Health First Colorado Provider Call Center at 1-844-235-2387 and select option 2 to "speak with an agent" and then option 4 to learn about interim payment options.
Thank you for the care and service you continue to provide to the 1.3 million Coloradoans covered by Health First Colorado (Colorado's Medicaid Program).
Health First Colorado (Colorado's Medicaid Program) and Child Health Plan