ColoradoPAR: Health First Colorado Prior Authorization Request Program

ColoradoPAR: Health First Colorado Prior Authorization Request Program

Attention All Providers


 

 

UM Vendor Update 
Keystone Peer Review Organization (Kepro) will be the new utilization management (UM) partner for Health First Colorado (Colorado’s Medicaid Program) as previously announced in the February 2021 Provider Bulletin (B2100459). Kepro is replacing eQHealth Solutions, Inc. and will begin to receive Prior Authorization Requests (PARs) for all Fee For Service Health First Colorado Benefits that eQHealth Solutions, Inc. currently authorizes no earlier than May 1, 2021.

About Kepro
Kepro delivers care management and quality oversight solutions using clinical expertise and technology-driven solutions to improve quality and clinical outcomes for vulnerable populations. Kepro currently holds both Quality Improvement Organization (QIO) and QIO-like designations from CMS. Kepro is Utilization Review Accreditation Commission (URAC) accredited and licensed to perform reviews in every state. Kepro brings 30+ years of Medicaid and Medicare experience, serving 27 Medicaid agencies over more than 20 years. They are one of the largest and most experienced federal, state, and local government review vendors in the nation, supporting government programs for over one billion covered individuals since 1985.

Provider Survey
Providers are invited to complete a provider survey to share opinions on provider portal functionality and training. All feedback will be considered to help make decisions regarding the UM program.

Provider Training Information
Save the date for an introduction to Kepro offered March 9, 10, or 11, 2021. Information on this provider training will be posted to the ColoradoPAR web page and communicated via email as soon as it is available.


Attention DMEPOS Suppliers: The 'multiple line item' policy instruction announced in the January 2021 Provider Bulletin is delayed until further notice due to operational issues. Providers are to continue coding claims and Prior Authorization Requests in their current manner. We apologize for the confusion.


The Department has announced the intent to award the Utilization Management (UM) contract to Keystone Peer Review Organization (KEPRO). Kepro will replace eQHealth Solutions, Inc as the UM Vendor in Spring of 2021. The go-live date for Kepro has not yet been finalized, but additional announcements will be posted to this website and sent out via Provider Bulletin. Please ensure that you are receiving the Department’s Provider bulletin by signing up to receive emails.


All live UM trainings presented by eQHealth Solutions, Inc are suspended as of January 4, 2021. Providers will still have access to the prerecorded eQHealth trainings on the ColoradoPAR website under Provider resources Providers can request a live training and or 1:1 help session if needed by sending an email to eQHealth's Provider relations team at co.pr@eqhs.com.


 

 
 

Upcoming Training Schedule

All live UM trainings presented by eQHealth Solutions, Inc are suspended as of January 4, 2021. Providers will still have access to the prerecorded eQHealth trainings on the ColoradoPAR website under Provider resources Providers can request a live training and or 1:1 help session if needed by sending an email to eQHealth's Provider relations team at co.pr@eqhs.com.

Items here are updated manually.

Contact Us

Customer Service Line: 888-801-9355 (toll free)

Provider Fax Line: 866-940-4288 (toll free)

Mailing Address: eQHealth Solutions (Attn: Colorado Medicaid Program)
5802 Benjamin Center Dr., Suite 105,
Tampa, Florida 33634

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