health first colorado provider services

You will be asked for a telephone number where you can be reached in the event that the call is disconnected. No annual benefit limit for adults or children. They can also connect you to resources you may need. No co-pay in therapy clinic or rehab agency. When you call the Nurse Advice Line you will always reach a live person who is ready to answer your medical questions. Dental and/or prosthodontics services are covered under the dental benefit. The generic equivalent will be given without prior authorization. Benefits that will be impacted in the coming weeks and months include the Supplemental Nutrition Assistance Program (SNAP food benefits) and Medicaid benefits. Calls are answered in the order they are received. Outpatient hospital services Forms. . Yes. P.O. Health First Colorado enrolled providers can prescribe any of the seven FDA-approved nicotine replacement therapy (NRT) and non-nicotine containing medications, all of which are on the Medicaid formulary and available to any Health First Colorado member at local pharmacies: Lab work Public health programs are where families turn for health care when faced with unemployment or loss of employer-based health coverage. Learn more about finding a primary care provider and how they can help keep you healthy. Hospitalization If you feel these rights have not been upheld, you can call the Behavioral Health Ombudsman at 303-866-2789, Email them at: [email protected], or go online at: We would like to acknowledge that the land we live, work, learn, and commune on is the original homelands of many tribal nations. We offer many types of programs for different types of people and each has a set of benefits. Family planning counseling 1 comprehensive (or complete) visit and 7-13 prenatal visits that last the whole pregnancy plus 60 days after giving birth, Delivery and inpatient maternity services, Newborn child coverage after a baby is born, Coverage for the whole first year after a baby is born. These services are available at no cost to you. Speech, physical and occupational therapy Select the category below that is most like yourself or the person youre seeking assistance for and contact us if you need more help. Health & Parenting Guide - Your Guide to Raising a Happy - WebMD Please keep in mind that some benefits may need prior authorization. Box 471 Basic fertility assessments and counseling to evaluate a members ability to become pregnant, Services to identify potential causes or reasons an individual is unable to become pregnant. For a members acute care home health needs lasting 60 days or less, members can get all necessary services without prior authorization or approval. For some services, you may have a co-pay. No co-pays for anyone 19 or younger; no co-pays for pregnant members. Contact Us | Health Colorado The Health First Colorado website and public messaging are made possible through grants from the Colorado Health Foundation and Caring for Colorado Foundation. Get more information about your benefits by contacting your primary care provider, regional organization, or the Member Contact Center. The nurses know about hospitals all over Colorado, as well as other resources you might need. Health First Colorado Manual del miembro en Espaol. Our care coordinators will help you. All information must be completed by the deadline provided to avoid losing coverage. Inpatient medical and surgical care Some durable medical equipment may have $1 a day co-pays. You may qualify for more. CCHA | Why Become a Provider - Colorado Community Health Alliance People who receive Old Age Pension (OAP) grants who do not qualify for other Health First Colorado programs. Parenting is one of the most complex and challenging jobs you'll face in your lifetime -- but also the most rewarding. Health First Colorado | Jefferson County, CO Investigative and experimental treatments are not covered, Specialist visit examples include being seen by a urologist, cardiologist or endocrinologist and others, Home health allows patients to get some care they need at home. National Provider Line: 1-800-397-1630 Clinical Authorizations: 1-888-502-4185 Carelon Behavioral Health EDI Help Desk: 1-888-247-9311 and press option 3, Monday thru Friday, 8 a.m. - 6 p.m. EST Mailing Address: Claims and Claims Appeals Carelon Behavioral Health Attn: Health First Colorado Claims PO Box 1850 Hicksville NY 11802-1850 Some pregnant people might also be able to get these services. Dental benefits, 3. Call your health care providers office if you need help with these. Make sure your contact information is up to date one of three ways: Visit Colorado.gov/PEAK Use the Health First Colorado app on your phone Boulder County Housing and Human Services Phone: 303-441-1000 or Text: 303-441-1069 It is important that your current contact information is up to date so you can receive these materials. Nurse Home Visitor Program for first time mothers. If you have your Health First Colorado ID number with you, please provide it to the nurse when you call. Immediate postpartum LARC insertion is covered. Additional family planning follow-up visits and services are covered when medically necessary. If you are on SSI and have not been enrolled in Health First Colorado or if you have not applied for OAP please contact Boulder County Department of Housing and Human Services at 303-441-1000. Behavioral health (mental health and substance use benefits). If you are denied Health First Colorado coverage, you may be eligible for other health care programs. PDF PROVIDER MANUAL - coaccess.com Before your in-person or telehealth appointment:Get Ready For Your Visit. PDF Colorado's Medicaid Program TOBACCO CESSATION BENEFIT Hearing aids may be replaced when they no longer fit, have been lost or stolen, or the current hearing aid is no longer medically appropriate for the child. Doctor visits Whats covered? Health First Colorado is public health insurance coverage for children, families, pregnant women, adults, the elderly, and people with disabilities. Coronavirus (COVID-19) is here in Colorado. Learn more about your benefits with these videos, For information on our quality initiatives click here, See the Health First Colorado Provider Directory, See the Colorado Access Provider Directory. Home Health Therapies (Physical therapy/ Occupational therapy/ Speech therapy), 60 days of treatment per acute (serious) condition, Only available to children 20 years old and younger, Speech therapies provided in the office, clinic, or outpatient hospital setting. Can they still help me? Explore programs for children, pregnant women, parents & caretakers, and adults. What happens next? Healthfirst Provider Services 1-888-801-1660. Physical assessment of detoxification progression including vital signs monitoring, Behavioral health counseling and therapy, individual, Alcohol and/or drug services, group counseling by a clinician, Alcohol and/or drug services, targeted case management, Safety assessment including suicide ideation and other behavioral issues, Level of motivation assessment for treatment evaluation, Pharmacologic Management of a patients medications, Outpatient Day Treatment, non-residential, Biologically-based mental illnesses and disorders, Mental Health and Substance Use Disorder Outpatient hospital and physician, Mental Health and Substance Use Disorder Inpatient hospital, Residential Treatment for Substance Use Disorder, Withdrawal Management (Detox Services) for Substance Use Disorder, Only available to children with Individual Education Programs, For a list of covered prescription drugs, please see the. This act states that there are not more limits on your behavioral health benefits than your physical health benefits. Health First Colorado is more than health insurance - it is a vital public service, helping almost one in five Colorado citizens stay healthy or move towards better health. We would like to show you a description here but the site won't allow us. Childrens Health Plan Plus (CHP+) is a low-cost health insurance program for eligible children and pregnant women who do not qualify for Health First Colorado. On the main navigation, choose Manage my benefits then Overview of health coverage benefits., Find renewal due dates for each household member under Summary of health coverage benefits., For answers to Medicare related questions call, Individuals and families who meet income limits, People ages 16-64 who are working and have a disability. I dont live in Denver. Rates and fee schedules. A co-pay is a fixed amount you pay when you get a covered health care service. Provider Responsibilities CMS 1500 Claims Specifications Present on Admission (POA) Indicator Diagnosis Coding Procedure Coding Anesthesia Billing Immunizations Multiple Occurrences Non-Clean Claims Process Locum Tenens Out-of-Area Services Corrected Claims Late or Additional Charges Member Billing or Balance Billing Missed Appointments 303-866-2993 303-866-4411 1570 Grant Street Denver, CO 80203 Pregnant members and children do not have to pay co-pays for prescription drugs. Emergency contraceptives, including over the counter with a prescription. Behavioral health assessment For more information visit Health First Colorado. Home visits until the child turns two years old. So when emergencies happen, your kids need world-class medical care. Caring for you and your health is our top priority. Some categories will consider resources. All ages: Replacement for current cochlear implant if broken/lost. Get help with medical conditions such as diabetes or asthma. There are several different programs. Ask Healthfirst. Covers Cochlear implants for only ages 20 and under, replacement when current unit is broken/non-functional. Limited to women age 40 and older and for younger women who are high risk. Yes. Improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado. Enrolling in Health First Colorado allows you to keep serving your existing patients during changing times. Detox This includes preventive services, like a wellness visit. Once you apply, we will contact you for a required interview. Boulder, CO 80306, Fax: 720-564-2283 Cervical and vaginal cancer screenings such as a pap smear test, Acute care (serious) issues allow any amount of medically necessary podiatric services. Pregnant members can be in the program for their whole pregnancy plus 60 days after giving birth. Private Duty Nurse who provides one-on-one care to patients. Step 2: Fill out, sign and return the forms, along with any extra required information. For Our Providers; Provider Services Provider Services. Call 800-283-3221 to: Any Health First Colorado member can call the Nurse Advice Line for help. In Colorado, Medicaid is called Health First Colorado. Training. Pregnant and parenting members can be in the program for their whole pregnancy and until their child turns one year old. 900 Jefferson County ParkwayGolden, CO 80401Phone: 303-271-1388Toll Free: 888-256-0321Email Us. More Info Well Care for Children and Youth (EPSDT Services) Learn more about these special health care services for members who are 20 years old or younger. Physical health benefits, 2. LEARN MORE OnTraq: Automating Safety and Efficiency through Smart Automation A co-pay is a fixed amount you pay when you get a covered health care service. Dental benefits, 3. There are several ways to apply for benefits. Telemedicine Member must be 21 years or older and mentally able to give informed consent. VIDEO: How the Medicaid and CHP+ Renewal Process Works English | Spanish. Can I change my appointments and refill my medication through this service? Surgical sterilization, including tubal ligation and vasectomies. You can choose whether your practice is published in our online Provider Directory. Telemedicine is a way of helping to get services to memberswho live far away from. Hours:Monday to Thursday7:30 a.m. to 5:30 p.m. Health First Colorado coverage gives you 3 kinds of basic benefits: 1. There is no limit on private duty nursing for children up to their 21st birthday. We are the regional organization for Adams, Arapahoe, Denver, Douglas, and Elbert counties. Health First Colorado coverage gives you 3 kinds of basic benefits: 1. Habilitative therapies may be available. Have health insurance questions or need an affordable, quality health plan? Health First Colorado (Colorado's Medicaid program) - Colorado Access For some services, you may have a co-pay. Department of Health Care Policy and Financing. Should I use the Nurse Advice Line if I have a question about my condition or medications? If you have Health First Colorado (Colorados Medicaid Program): Please visit healthfirstcolorado.com/covid for the most up-to-date benefit information. All rights reserved. If you have Health First Colorado (Colorados Medicaid Program) or Child Health Plan Plus (CHP+), make sure they have the right contact details for you. If you receive SSI and have not been enrolled in Health First Colorado, please contact your local county department of human/social services. Breast pumps must be prescribed by a physician, physician assistant, or nurse practitioner. First Name * Last Name * Phone Number * Email Address * Home Zip Code . A care coordinator can assist you in coordinating physical and behavioral health services, and other related services, such as transportation for medical appointments. Health First Colorado Member Handbook, Spanish Version Requires a prescription from a doctor or a pharmacist. The normal Medicaid renewal process is starting in May. Call the Department of Human Services Office of Behavioral Health at 303-866-7400to find a provider in your area. The normal Medicaid renewal process is starting in May. For more information regarding your overall healthcare talk to your primary care provider or regional organization. Members whove declared their pregnancy will also be guaranteed coverage for the 12 months after their pregnancy ends. Ambulance rides Special Connections Program is for pregnant members who struggle with alcohol and/or drug misuse. Primary Care Learn more about finding a primary care provider and how they can help keep you healthy. Health First Colorado (Colorados Medicaid Program), Now that youve applied for Health First Colorado (Colorados Medicaid Program) and the Child Health Plan Plus (CHP+) you probably have questions. As a result of the novel coronavirus disease (COVID-19) pandemic, the Department of Health Care Policy & Financing (the Department) is asking health care providers to join us in ensuring all Coloradans have access to quality health care during this public health crisis by becoming a Health First Colorado (Colorado's Medicaid program) provider. $2 per visit if not part of an emergency room. Health First Colorado is public health insurance for low-income Coloradans who qualify. Yes. You dont need a referral. The nurses will also ask for your zip code, which will help nurses identify your area and available resources. Private duty nursing is limited to 16 hours a day for adults. 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