Provider Services
Welcome to the Provider Services page for the Colorado Medical Assistance Program. This site contains helpful information for Medical Assistance Program providers and other interested parties. It also provides links to other valuable information.
Please scroll down to access the Colorado Medicaid Fee Schedule information.
Please continue to check the Provider Services sections for updated information about the fiscal agent operation and the Colorado Medical Assistance Program.
If you are Interested in becoming a Colorado Medicaid Provider...
Please click on the Enrollment tab on the left-hand side of this page. For Providers not yet enrolled or providers already enrolled in the Colorado Medical Assistance Program please refer to the appropriate Enrollment section.
For questions please contact:
| Department's Fiscal Agent | Hours of Service | Phone Number |
| Xerox State Healthcare | 8:00 a.m. - 5:00 p.m. | 1-800-237-0757 (Toll Free) |
Holiday Payment Processing Schedule
For some State and Federal holidays, payment processing dates are changed to minimize provider payment delays. When the holiday falls on a Monday, claim payments are processed on Thursday instead of Friday. The processing cycle includes electronic claims accepted before 6:00 p.m. on the previous Thursday.
The schedule below shows the holiday payment processing date for May 2013.
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Holiday
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Date of Holiday
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Payment Processing Date
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Memorial Day
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Monday, May 27
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Thursday, May 23
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Valuable Information
Web Portal Changes due to Second Phase of National Correct Coding Initiative (NCCI) Implementation
As a reminder, Web Portal users will notice that a response of “To be paid” and “To be denied” will no longer be an immediate response when submitting claims. Users will need to check the status of the claim(s) on the next business day by submitting a Claim Inquiry transaction. Please refer to the March 2013 Provider Bulletin (B1300334) or contact the Department’s fiscal agent at 1-800-237-0757 with any questions.
Non-Medical Transportation (NMT) Prior Authorization Requests (PARs)
Recently client PARs may be displaying revised NMT rates presented in January 2013. The revised NMT rates have not yet been finalized by the Department. In order to ensure clients have the necessary NMT trips authorized for July 1, 2013, case managers were required to start PAR revisions in March 2013. Any changes to the rates will be updated on the PARs and in the Medicaid Management Information System (MMIS) prior to July 1, 2013. The Department is currently reviewing all feedback received by providers during January-March 2013. The final decision regarding NMT rates will be communicated to providers at a formal meeting held at the Department on May 13, 2013. In order to accommodate all providers please RSVP if planning to attend in person.
Please RSVP to Nicola Jackson at Nicola.Jackson@state.co.us. Additional information regarding the meeting location and call-in information will be published in the May 2013 Provider Bulletin.
Payment Error Rate Measurement (PERM) Information
Provider Education - Waivers
ColoradoPAR is Currently Processing a Variety of PAR Types
For more information about the PAR types processed by the ColoradoPAR Program and available training, please go to www.coloradopar.com.
HIPAA Updates
For updated implementation information and current 5010 Companion Guides, please go to the Provider Services Specifications section.
Protected Health Information (PHI)
The Department's policy for sending and receiving PHI electronically.
For more information on…
CHP+ Health Plan Enrollment Verification Fact Sheet
Fiscal Agent Name Change from ACS, A Xerox Company, to Xerox State Healthcare
OP Hospital Supplemental Medicaid Payment
The Accountable Care Collaborative
Accountable Care Collaborative PCMP Rates
24 Hour Nurse Hotline, 1-800-283-3221
Did you know that Medicaid offers this free service to all of its Primary Care Physician Program and fee-for-service clients? Whenever a client is hurt or sick, please encourage him or her to call the nurse hotline prior to seeking treatment. This can help reduce unnecessary emergency room and office visits and allow providers more time to spend with those who truly need medical attention. By promoting this nurse hotline to your Medicaid patients, it enables an RN to assess the client's condition and direct his or her care appropriately. This service is available after hours too! For more information, or to request promotional materials, please contact the Department at 303-866-3513 or 1-800-221-3943.
Colorado Medicaid NCCI Disallowable Code Pairs - February 14, 2011
| Medicaid Fee Schedules |
| NF PETI Fee Schedules |