Latest from CO Dept. of Health Care Policy & Financing (HCPF)

HCPF recently launched a new Claims Payment System, the Colorado interChange, for processing payments for Health First Colorado (Medicaid) and Child Health Plan Plus (CHP+). In addition, a new Provider Web Portal and a new Pharmacy Benefits Management System (Pharmacy Point of Sale system) were also recently launched. This was not only a transition to new systems, but to new vendors and new processes. The transition appears to be rough; you, along with other clinics, may be experiencing problems!

"There are a number of resources available on the Department’s website. Here they are in one place:

Provider Web Portal

Provider Web Portal Recorded Webinars

Provider Web Portal FAQs (scroll down webpage) and Web Portal Cheat Sheets:

·         Copy, Adjust, or Void a Claim

·         Delegates

·         Provider Maintenance

·         Updating your EFT/ERA Information

·         Validating a Trading Partner ID (TPID)

·         Verifying Member Eligibility

Provider Resources – includes updates on suspended claim status.

Go-Live Guide – identifies changes to Late Bill Override dates on page 6. Please check the updated billing manual for timely filing rules.

Other notes:

·         There is a resolution for denials due to  EOB 1473 – ‘Multiple Provider Locations for Billing Provider Specialty.’ These claims will need to be rebilled starting tomorrow morning 3/10/17. This will be communicated out on the web portal.

·         Submitting claims in provider web portal – the error message when submitting claims has been resolved.

·         An additional financial cycle ran on Tuesday 3/7, in addition to the first financial cycle which ended on Sunday night at 7pm.

·         To register for an account on the Provider Web Portal, the display name cannot have a space (e.g. JohnDoe not John Doe). Please see this work-around for more information.

·         HPE wait times and dropping of calls (not on purpose) is HPE’s highest priority; hiring and training additional agents

o   Providers can check member eligibility through an automated voice system, call 1-844-801-8478.

o   Otherwise, continue to call 1-844-235-2387 or visit the Provider Resources website."