Utilization Standards/Medical Billing Disputes

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What are Utilization Standards?

This rule includes terminology, administrative procedures and dispute resolution procedures to implement the Division’s Medical Treatment Guidelines and Medical Fee Schedule. To view Rule 16, please click here.

Medical Billing Disputes

The Division’s Medical Dispute Resolution Unit is available to resolve disputes resulting from a violation of Rules 11, 16, 17 and 18. Please contact 303-318-8765 or cdle_medicalpolicy@state.co.us with any questions.

Forms

  • WC181 - Medical Billing Dispute Resolution Intake Form (PDF) | (Word)
  • WC188 - Prior Authorization (PDF) | (Word)
  • WC195 - Notification by an Authorized Treating Provider (PDF) | (Word)
  • Evaluation and Management (E&M) Audit Form (PDF) | (Word)
  • Desk Aid 15 - Discharge or Refusal Form Letter FlowChart (PDF) | (Word)

Contact Us

Colleena Blakeman-Groves
Medical Dispute Resolution Unit
633 17th Street, 3rd Floor
Denver, CO 80202
P 303-318-8765 
F 303-318-8758 
colleena.blakeman@state.co.us

 

Nina Fresquez
Medical Dispute Resolution Unit
633 17th Street, 3rd Floor
Denver, CO 80202
P 303-318-8766 
F 303-318-8758 
nina.fresquez@state.co.us