Go Live Postponement FAQs
In October, the Department of Health Care Policy & Financing (the Department) announced its decision to postpone the Go Live date of its new Colorado interChange, including the provider and member web portals and the Pharmacy Benefits Management System. The new Go Live date is March 1, 2017.
Why is the Department postponing?
The new Go Live date allows us to conduct more systems testing, better define system and business process changes and devote more time to working with our providers to ensure they are revalidated and enrolled in the Colorado interChange system.
How long is the postponement?
The Go Live date has been postponed four months. The original go live date was October 31, 2016 and the new date is March 1, 2017.
Can providers who are in the process continue with revalidation or will there be a disruption in the process?
Providers who have already begun the revalidation process should continue with their application. There will be no disruption to the processing of applications. Providers who have not started the revalidation process should start immediately.
The revalidation deadline was September 24, does this mean providers can no longer revalidate?
No, provider revalidation is the number one priority of the Department. We are and will continue to work with our providers to complete revalidation process prior to Go Live on March 1, 2017.
Will there be any additional assistance beyond the Health First Colorado Enrollment and Revalidation Information Center?
On October 31, Hewlett Packard Enterprise (HPE), now DXC Technology, assumed operation of the Health First Colorado Enrollment and Revalidation Information Center for assistance with the provider revalidation application.
Providers should call the Health First Colorado Enrollment and Revalidation Information Center (at 1-844-235-2387) for questions or concerns about the provider revalidation application.
Providers should continue to call Xerox (at 1-800-237-0757) for questions or concerns about current business processes.
If you don’t know which number to call, view this quick guide to help you determine who to call.
If a provider has completed the revalidation process and needs to make changes before March 1, 2017, can they update their information?
Yes. If providers need to make changes, they should follow the current process with Xerox to update their information. We are working with HPE, now DXC Technology, to determine whether we can launch the new provider portal on October 31, 2016. This has not been finalized, we will communicate with providers and partners once details are available.
Will managed care organizations continue receiving eligibility files in the same format and same process as they do now? (Will the new 834 eligibility file transition be delayed to the March 1, 2017 Go Live date?)
Yes. The transition to the 834 eligibility file is being postponed to March 1, 2017. Please resume all current business processes.
Will managed care organizations (MCOs) and RCCOs continue to receive a weekly Application Tracking Number (ATN) or revalidation report?
Yes. Provider Revalidation is the Department’s top priority and we want our MCOs, RCCOs and partners to treat revalidation with the same amount of urgency.
Where do we sign up for web portal training?
Provider web portal training registration and instructions can be found on our Provider Resources web page.
Should providers continue to take provider web portal training?
Providers can and should take advantage of the training. With a new Go Live date, providers have more time to become familiarized with the provider web portal.
Payment and business processes
Will the new the Enhanced Ambulatory Patient Grouping (EAPG) payment policies still be effective on October 31, 2016?
Yes. Hospital providers are instructed to submit claims using CPT/HCPCS codes in accordance with the Enhanced Ambulatory Patient Grouping (EAPG) payment policies which will have an effective date of October 31, 2016. This change has not been pushed back, even with Go Live Postponement. For more information regarding these policies, please visit our Outpatient Hospital Payment page.
Will there still be a payment delay this month (October 2016)?
There will not be a payment delay this month. However, providers should expect a delay in payment closer to the new Go Live date. This is unavoidable and will occur for all providers. We will share the date for the payment delay as soon as we finalize the timeline.
How should providers submit claims?
Please conduct business as usual. Providers should continue to submit claims using the current processes. The exception is for hospitals billing outpatient services. Hospital providers are instructed to submit claims using CPT/HCPCS codes in accordance with the Enhanced Ambulatory Patient Grouping (EAPG) payment policies which will have an effective date of October 31, 2016. For more information regarding these policies, please visit our Outpatient Hospital Payment page.
Will providers continue to get paid?
Yes, providers will be paid as usual. The Go Live postponement will not cause any disruption to payments (at this time). For hospital outpatient claims, payment will be made using the established methodology relying on percentage of charge. After interChange launch, these claims will be re-processed and paid using the EAPG methodology.
Will Prior Authorization Requests (PARs) be processed and approved?
Yes, please continue to submit PARs using the current business process. The process for approvals and payment will not change until Go Live.