Colorado Prior Authorization Requests Program (CO-PAR)
What is the ColoradoPAR Program?
The ColoradoPAR Program is Colorado Medicaid’s utilization management (UM) program.
What is Utilization Management (UM)?
- UM is a set of guidelines that help to ensure clients receive the right services and supports at the right time, and for the correct duration.
- The UM program improves quality of care and saves the taxpayer money because it decreases unnecessary and duplicative services.
Who Performs UM activities for Colorado Medicaid?
- APS Healthcare Midwest administers the ColoradoPAR Program as Colorado Medicaid’s UM vendor.
- To learn more, please visit www.ColoradoPAR.com.
What are the Goals of the ColoradoPAR Program?
- Improve health outcomes of Medicaid clients;
- Decrease costs by eliminating duplicative and unnecessary services; and
- Allow providers to easily track the status of their prior authorization requests (PARs) using a web portal, rather than a paper process.
What activities does the ColoradoPAR Program perform?
- Prior Authorization Requests (PARs) – Providers are required to get authorization before providing certain services. Providers request authorization for services through CareWebQI, ColoradoPAR’s provider web portal.
- The UM Vendor reviews the request to determine if services are medically necessary according to established criteria and guidelines.
- Retrospective reviews – the UM Vendor looks at care that has already been provided to ensure care is appropriate and claims are accurately submitted and paid.
- Consult with the Department on medical management – assist with planning, coordination and evaluation of care to cost-effectively improve health outcomes.
Medicaid Provider Contact:
Colorado PAR: 1-888-454-7686
Medicaid Client Contact:
Customer Service: 1-800-221-3943