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

• SIM releases third and final application for cohort 3
• Medicaid Primary Care Payment Reform - read the survival guide & complete the APM Measure Selection Survey!

Colorado interChange: Resources for your Membership Week of November 16, 2017

We'll use this newsletter to provide you with updates on the implementation of the Colorado interChange, including topics you might be hearing from your members as well as content for your membership newsletter and general updates on progress.

Provider Buzz

Here's a look at hot topics for providers and others: You may have been hearing a lot about "the Bridge" from case managers. The Bridge is a system used by case managers for Home and Community Based Services (HCBS) to submit Prior Authorization Requests (PARs)-- the Bridge is not used for medical PARs. Only after a PAR is approved is it transmitted to the Colorado interChange for processing. It takes at least one day, after the PAR is approved in the Bridge, to appear in the Colorado interChange and be available for claims processing.  In early October, the Department made initial awards for seven Regional Accountable Entities (RAEs) for the next iteration of the Accountable Care Collaborative (ACC). Following those awards the Department received formal protests. In accordance with State procurement rules, the Department is prohibited from discussing the solicitation, contract awards and negotiations until all protests and appeals are resolved. The Department is continuing to prepare for the implementation of the next phase of the ACC as these protest are resolved. Read more about implementation goals and timeline. If Congress fails to act on funding for the Children's Health Insurance Program, or Child Health Plan Plus (CHP+) in Colorado, the program will end on January 31, 2018. Prior to that, families using the program will begin receiving information about the potential program end in late November. As of today, there are no changes to CHP+ benefits and providers are urged to keep serving CHP+ members at their practices. Even if Congress does not act to renew CHP+ funding, enrollment and redetermination of CHP+ members will continue through the planned program end on January 31, 2018. Resources are available to help providers communicate with their CHP+ patients about the status of the program.

News You Can Use

Here's some content for membership newsletters: New help for provider revalidation and enrollment   Providers still struggling with revalidation or enrollment-- the first step to successfully using the Colorado interChange for claims -- can get additional help with issues they face. The Colorado Department of Health Care Policy and Financing recently released a new webinar aimed at answering common questions and issues with the process. The hour-long webinar tackles topics like revalidation documentation, web portal registration, best practices as well as solutions for the top five reasons revalidation and enrollment will deny. Following the webinar, participants were able to ask questions.

Colorado interChange Numbers

Since March 1, 2017... More than $5.5 billion paid to providers 35.6 million claims have been processed  In our latest financial cycle on Friday, Nov. 10 ... $130 million paid to providers 953,345 claims processed As a reminder, the Department frequently updates its Known Issues & Updates web page with new issues, work arounds and resolution ETA.