The Colorado Immunization Program (CIP) at the Colorado Department of Public Health and Environment is assisting local public health agencies (LPHA) develop the mechanisms to bill health insurance plans for services provided to health plan members.
These funds support LPHA with a new pilot program opportunity called “Reimbursement Immunization Opportunity” or RIZO. The RIZO project involves the following:
Monthly Project RIZO calls are held on the third Tuesday of every month at 1:00 pm, unless participants are notified otherwise. To add yourself to the distribution list for these meetings, please contact Cathleen Beaver via email.
For more information on Project RIZO, please contact:
Colorado Immunization Program
In-state toll-free:1-800-886-7689 ext. 2732 (Teri)
RIZO contractors are required to report monthly for the RIZO activities completed during each month. Additional follow-up contact may be made periodically by the CIP contract monitor.
RIZO projects are required to collect, track, document, and report the following data as applicable:
Throughout the funding period, the CIP will conduct ongoing project monitoring and provide technical assistance as needed. In the event that project performance does not meet the agency's stated goals, a follow-up work plan will be created and additional technical assistance will be provided. In an extreme situation, and in consultation with the agency, the CIP reserves the right to reduce or withhold quarterly payments due to poor project performance.
Project RIZO: On-Site Data Collection
The RIZO Data Collection Template is a simple spreadsheet used to capture general, patient-level data about the patients you serve, the vaccinations those patients receive, and the insurance payer (public or private) for those patients. This data is supplied to the CIP without patient identifiers and analyzed in an attempt to better quantify the billing opportunities in Colorado. Periodically, the CIP will supply contractors with analysis of the data they submitted for their jurisdiction. Analysis might include, but is not limited to:
Unless notified otherwise, all RIZO contractors are required to complete a RIZO Data Collection Template form monthly and submit the form by the 5th day of the following month to Jodi Maturo via email.
Project RIZO: Off-Site Data Collection
Data Collection at off-site clinics, such as School Located Vaccination (SLV) clinics is equally important. The data you capture at your off-site clinics helps us identify the most common payer sources of students served and the vaccinations those students received. Much like on-site data collection, these data are supplied to the CIP without patient identifiers and are used to assess the billing opportunity of an off-site clinic. A data collection template must be completed for each off-site clinic your agency implements as part of Project RIZO.
Your completed template is due within 2 weeks of the clinic date and should be sent to Marget Huffman via email.
The process for Project RIZO contractors to bill the CIP varies by the source of funding, as shown below.
Note: Project RIZO invoices should include charges for both on-site activity and school located vaccination clinics (SLV). Your invoice does not need to be itemized according to the location of the immunization clinic.
Have questions? Please contact Teri Lindsey at 303-692-2732 or by email for more information.
Two Medicaid care options in Colorado:
How do Local Public Health Agencies (LPHA) apply to be Medicaid providers?
How does an LPHA determine whether to be a straight Medicaid provider or a MCO Medicaid provider?
How do I check eligibility for a Medicaid patient?
How do I bill for immunizations?
Two CHP+ care options:
Structure: Colorado Access is the Administrative Service Organization (ASO) that administers the State CHP+ plan called the State Managed Care Network (SMCN). When a child first joins CHP+, he or she will be initially covered by SMCN for approximately 1-2 months before transitioning to their HMO for the duration of their membership. These children receive full CHP+ services through the SMCN during this “pre-HMO” period. However, CHP+ enrolled patients who live the counties of Teller, Sedgwick, and El Paso do not have HMOs and will all be served by the SMCN network exclusively.
How does an LPHA determine whether to be an SMCN or HMO CHP+ provider?
How do I begin the CHP+ provider application process?
What are the reimbursement rates for CHP+ SMCN and HMOs?
Already a CHP+ provider?