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Are your billers and claims specialists receiving Department email notifications? Oftentimes, only the credentialing specialist who originally enrolled the provider is subscribed to our mailing list. To make sure the appropriate person within your practice is getting the information they need, please invite them to sign up here. Under Email Lists, select “00 – All Provider Emails to receive: 1) a weekly Last Week in Review newsletter, which includes Hot Topics, Featured Provider Resources, and status updates on Known Issues; 2) a monthly notification when the Provider Bulletin is published; and 3) occasional general announcements relevant for all providers. Select your provider type to subscribe to communications specific to your provider type, including status updates on Known Issues. Also, make sure to keep contact information up to date in the Provider Web Portal.
An upcoming change to the Provider Web Portal password requirements will require all Web Portal users to change their passwords from 8 characters to 9 characters. Once this change goes into effect, Web Portal users will be prompted to reset their password to 9 characters the next time it is about to expire.
Effective 11/26/19, the Provider Web Portal has been updated so that providers can add the newly obtained National Provider Identifiers (NPIs) to their enrollment records.
Off-campus hospital locations should refer to the Hospital Provider Adding an NPI Provider Web Portal Quick Guide located on the Quick Guides and Webinars web page for detailed instructions on how to add a new NPI to the enrollment records. Providers should add the new NPI by doing a provider maintenance update. Providers should not attempt to submit a new application.
If the provider requests to add a new NPI to the enrollment record, the previous NPI will remain for history purposes and have an end date.
The Colorado NPI Law requires new Organization Health Care Providers (those not enrolled) and all off-campus hospital locations to enroll with and submit claims using a unique NPI that is associated with the provider type and service location by 1/1/20.
Providers are encouraged to visit the Colorado NPI Law web page for additional information, or contact Provider Services Call Center at 1-844-235-2387 with questions regarding the Colorado NPI Law.
Effective 10/2/19, the Colorado interChange has been updated to ensure that State Funded MHIs are paid correctly for Medicare crossover claims. Services that have been provided since 3/1/17 with incorrect payment or no payment will be reprocessed.
State Funded MHIs are now able to bill Medicaid for room and board and Medicare for the ancillary expenses. MHIs must manually enter the Medicare ancillary payment and the final payment should equal the Medicaid allowed amount payment (per diem x days) - Medicare payment (ancillary x days).
The Provider Web Portal has been updated to allow providers to use a new Part B only/Part A Exhausted checkbox when billing inpatient crossover claims for members that have TXIX benefits and Medicare Part A benefits during the stay.
The Affordable Care Act requires providers to complete revalidation every five years. The next round of revalidation will begin in October 2020, based on previous provider enrollment approval dates. Providers will be contacted via email approximately six months prior to their exact revalidation deadline with further instructions.
Visit the Revalidation web page for more information and links to additional resources.
Effective 9/3/19, the provider type Dentist with the specialty of Oral Surgeon is now accepting a copy of the Oral Maxillofacial Surgery (OMFS) certification and hospital privileges in lieu of a physician license. Refer to the Dentist drop-down section of the Information by Provider Type web page for a full list of requirements for this specialty.
House Bill (HB) 18-1282, the Colorado National Provider Identifier (NPI) Law, requires newly enrolling and currently enrolled Organization Health Care providers (not individuals) to obtain and use a unique NPI for each service location and provider type enrolled in the Colorado interChange. Providers are encouraged to visit the Colorado NPI Law web page for additional resources and information, including the Colorado NPI Law FAQs for Providers and fact sheet.
Completed Additional Reprocessing for Anesthesia Providers - Fiscal Year 2019-2020 Provider Rate Increases and Adjustments 11-4-2019
Additional Reprocessing for Anesthesia Providers - Fiscal Year 2019-2020 Provider Rate Increases and Adjustments 10-25-2019
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