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The purpose of the Act is "..make credentialing more efficient, less costly, and less duplicative by making it uniform through the use of a single application form for the collection of core credentials data...".
The Colorado Health Care Professional Credentials Application (CHCPCA) became effective for initial credentialing in Colorado January 1, 2006.
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On September 30, 2015, online member eligibility, benefit and claim status inquiries will only be available at Avoid business disruptions – work with your office staff today to register for and begin using the Availity Web Portal.Provider One Billing and Resource Guide The appendixes below are included in the complete guide. Appendix A - Use interactive voice response (IVR) to verify eligibility Appendix B - Verifying eligibility using a magnetic card reader or MEV service Appendix C - Managed care organizations (MCOs) Appendix D - Casualty claims and health insurance claims Appendix E - Benefit services packages Appendix F - Instructions to fill out the General Information for Authorization Request form Appendix G - How to check status of an authorization Appendix H - Cover sheets for backup documentation Appendix I - Taxonomy and Provider One Appendix J - Medicare crossover claim payment methodology Appendix K - Checking claim status with IVR Appendix L - Checking warrants with IVR On October 1, 2016, we implemented a paperless billing policy where all Apple Health (Medicaid) providers (excluding Tribal billing offices) are required to submit electronic claims for Apple Health (Medicaid) services.Providers may seek approval to submit paper claims if they are in a temporary or long-term situation outside of their control that precludes submission of claims electronically.The agency's Provider Relations team hosted two webinars focused on billing electronically through the Provider One portal to assist those providers who have not transitioned to electronic billing.
The links to these webinars, the waiver form, and an FAQ on the paperless policy can be accessed below: Note: We make updates as needed to reflect current policy, program updates, and Provider One system enhancements.Effective May 1, 2006, the Colorado Department of Public Health and Environment announced that the same form shall be effective for re-credentialing in Colorado as well.