Denver Health Medicaid Choice (DHMC) process changes

Click here to view more information on the Denver Health Medicaid Choice (DHMC) process regarding disenrollment request, authorization request and claims submission related to passive enrollment. Below are highlights from the letter, please be sure to read the full letter carefully.

• Disenrollment process: Any non-DH provider that has an existing relationship with a member who has been passively enrolled into DHMC can assist the member to contact HealthColorado either by phone or by faxing form to request disenrollment (fax # 303-832-8352).
• Process for providers to obtain authorization from DHMC regarding passively enrolled members: Providers must submit (via fax 303-602-2128) an “Outpatient Provider Referral Form.pdf” to the Denver Health Managed Care Utilization Management (UM) department.
• Process for providers to obtain claims reimbursement from DHMC regarding retrospective claims for passive enrollees:  DH MCD Choice shall reimburse any non-DH provider rendering primary care services to a passively enrolled member for dates of services 120 days prior to the date of disenrollment from DH MCD Choice. All retrospective claims must be submitted via fax (preferred method) at 303-602-2096 to DHMC by December 31, 2014.