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Frequently Asked Questions

 

Eligibility | Electronic Reports | Software Vendor |  FINANCE FAQs: | Electronic Funds Transfer (EFT) | Paper Checks/Warrants | Accounts Receivable (AR) Balances | Notification of Non-PaymentCommon Billing Questions | Web Portal 

   

 

 

Eligibility 

 

Q: Who determines a client's eligibility?
Q: What is delayed/retroactive eligibility?
Q: How do I check to see if a client is eligible for Colorado Medical Assistance Program benefits?
Q: How do I get setup for Fax-Back?
Q: What are Load Letters and Late Bill Override Dates?
Q: What is Dual Eligibility?
Q: What is Presumptive Eligibility (PE)?
Q: What is the Modified Medical Program?
Q: What are Qualified Medicare Beneficiaries?
Q: Are non-citizens eligible for Medicaid benefits?

  

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Electronic Reports

 

Q: How can I retrieve Accept/Reject and Provider Claim Reports electronically?
Q: Who do I call to get set up for electronic report retrieval?
Q: How do I retrieve Provider Claim Reports from the Web Portal?
Q: If several group providers want to get all reports under a single trading partner ID, how do we complete the EDI enrollment packet?
Q: For what length of time are the reports available electronically?
Q: How do I request a copy of my PCRs?

 

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Software-Vendor

 

Q:I am a software vendor interested in programming a practice management system. Where can I get a copy of the Colorado Medical Assistance Program Specification Manual(s)?

 

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FINANCE FAQs 

 

Electronic Funds Transfer (EFT) 

 

Q:Is EFT a requirement?
Q:How do I set up EFT?
Q:How long does it take to set up/update EFT?
Q:If my bank information changes do I have to submit a new EFT document?
Q:Why doesn¿t my EFT deposit show in my account

 

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Paper Checks/Warrants 

 

Q:I did not get my check. Is my check lost? Has it been cashed?
Q:How can I get a copy of my cashed check?
Q:How can I get my check reissued?
Q:What if I forgot to notify Provider Enrollment of an address change?
Q:How do I cancel a future check if I have moved and I have not updated my contact information?
Q:Is there a better way to receive Colorado Medical Assistance Program payments?

 

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Accounts Receivable (AR) Balances 

 

Q:How can I find out about an AR balance?
Q:What creates an AR balance?
Q:I have paid my AR balance (have a canceled check) but my PCR still shows the balance. How do I resolve this?

 

 

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Notification of Non-Payment 

 

Q:Why am I getting a Notification of Non-Payment letter?
Q:Why am I now being told I need a new provider number? I¿ve always been a PC (or LLC, or ¿.)
Q:What is an IRS 147 C Letter and why is it requested?
Q:Why do I have to send a W-9 in more than once?
Q:I am an enrolled Colorado Medical Assistance Provider, but bill infrequently. Why do I have to complete another W-9?
Q:When does the provider bill using the group provider number vs. the individual¿s provider number?

 

 

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Common Billing Questions

The following questions and answers are designed to help all providers with common problems that often occur when billing the Colorado Medical Assistance Program.  

 

Q:I am a Colorado Medical Assistance Program provider who submits electronic claims. How do I know when to call ACS EDI Services or ACS Provider Services?
Q:What should I do if my Medicare claim didn¿t automatically crossover?
Q:How long should I retain client records?
Q:What is an LBOD, and how do I use it?
Q:What is a Delay Reason Code?
Q:What should I do if the PHP (Pre-paid Health Plan) denies the claim for "Not a benefit"?
Q: Why am I receiving an electronic billing rejection telling me to bill on paper?
Q:How do I bill the Colorado Medical Assistance Program if I have a contractual write-off with another insurance?
Q:Where can I find CHP+ information?
Q: How can I get a Colorado Medicaid fee schedule?
Q: How do I bill for a baby's charges when the baby doesn't have a Colorado Medical Assistance Program client ID number?

 

 

 

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Web Portal  

 

Q:What is the Web Portal?
Q:I am a Colorado Medical Assistance Program Provider that is interested in submitting claims electronically through the Web Portal. What should I do?

 

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