Billing Tools

The procedures and policies for submitting Pharmacy claims can be found in the Pharmacy billing manual. Related billing forms are listed below. Please refer to Provider Services for more information.
 

• Pharmacy Billing Manual
   
• Pharmacy Claim Form
   
• CO-1500 Claim Form
   
• Certification & Request for Timely Filing Extension - Delayed Eligibility Notification Form
   
• Request for Resconsideration Form
   
• IHS Pharmacy Billing Training

Provider Enrollment

Please refer to Provider Services ⇒ Enrollment for more information.

• Pharmacy Checklist
   
• Standard Application
   
• Out of State Letter
   
• Dispensing Fee Attestation Form

 

OCC Training Information

• Flow Chart
   
• Quicksheet

Department of Health Care Policy and Financing · 1570 Grant Street · Denver, CO 80203-1818 · (303) 866-2993 Phone · (303) 866-4411 Fax