Copyright 2023. Yes. Does not include orthoptic or eye training therapy. Health First Colorado pays faster than most private payers! As a Health First Colorado (Colorado's Medicaid program) provider, you have the opportunity to improve the health and well-being of more than a million Coloradans. Outpatient hospital services Prior authorization is approved for 6-12 months at a time, but a client can get an unlimited number of prior authorizations. Pregnant members do not have to pay co-pays. Cleft palate surgery, bariatric surgery and dental anesthesia may be covered. Telemedicine is a way of helping to get services to memberswho live far away from. For some services, you may have a co-pay. While working with the Centers for Medicaid and Medicare Services (CMS), Health First Colorado (Colorado's Medicaid Program) has established that regional organizations are required to reimburse for medically necessary services covered under the scope of their contract for providers in their network who are unable to enroll in Medicare. You may qualify for more. As a Health First Colorado (Colorado's Medicaid program) provider, you have the opportunity to improve the health and well-being of more than a million Coloradans. Members whove declared their pregnancy will also be guaranteed coverage for the 12 months after their pregnancy ends. Broker Services 1-855-456-3668. . Select the category below that is most like yourself or the person youre seeking assistance for and contact us if you need more help. Treatment for infertility causes is not covered. Keep in mind that some benefits may need prior authorization. Some services, however, may require a prior authorization. Are you having a technical or payment issue? Specialist visits In Colorado, Medicaid is now known as Health First Colorado (Colorados Medicaid Program). Find Doctors & Other Providers Member Benefits & Services Our care coordinators will help you. It is important that your current contact information is up to date so you can receive these materials. Parenting is one of the most complex and challenging jobs you'll face in your lifetime -- but also the most rewarding. Once you apply, we will contact you for a required interview. Fax: 303-441-1523 Replacements expected every 3-5 years. Health First Colorado coverage gives you 3 kinds of basic benefits: 1. Some pregnant people might also be able to get these services. English Version The generic equivalent will be given without prior authorization. Audiology services such as hearing aids and cochlear implants. Speech, physical and occupational therapy Doctor visits Member Contact Center 1-800-221-3943 / State Relay: 711, Learn more aboutHospital Emergency Services, Learn more aboutNon-Emergent Medical Transportation, Health First Colorado Manual del miembro en Espaol, Primary Care Medical Provider Visit for Illness or injury. 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. We offer many types of programs for different types of people and each has a set of benefits. Eligible adults enrolled in Health First Colorado in Colorado now have access to up to $1,000 per year in preventive dental care. Radiology For Our Providers; Provider Services Provider Services. Ambulance services and other non-emergent transportation. Department of Health Care Policy and Financing. The Nurse Advice Line cant help with clinic appointments or medication refills. Informed Consent Form required for surgical sterilization. Get advice on the type of doctor that may be right for your medical condition. Our network of behavioral health providers can provide medically necessary behavioral health services. Boulder County, CO. All Rights Reserved. Health First Colorado Add-A-Baby Emergent Request Form, Locate Medicaid and Child Health Plan Plus providers, Department of Health Care Policy and Financing, State Supreme Court Upholds Hospital Provider Fees, Bills to Improve Long-Term Care Signed into Law, U.S. Supreme Court Upholds the Affordable Care Act, Polis Administration Releases New Prescription Drug Report - Assembles More Than 1600 Colorado Leaders to Tackle Prescription Drug Costs. If you have your Health First Colorado ID number with you, please provide it to the nurse when you call. When I call, do I need to provide any information? for the most up-to-date benefit information. VIDEO: How the Medicaid and CHP+ Renewal Process Works English | Spanish. If you have Health First Colorado (Colorados Medicaid Program). How do I get care? Public health programs are where families turn for health care when faced with unemployment or loss of employer-based health coverage. Enrolling in Health First Colorado allows you to keep serving your existing patients during changing times. Breast reconstructive surgery may be covered for members with a history of breast disease diagnosis and surgical procedure within the prior 5 years. You will be on the Dashboard. Learn more about these special health care services for members who are 20 years old or younger. Before your in-person or telehealth appointment:Get Ready For Your Visit. Investigative and experimental treatments are not covered. All FDA approved contraceptive methods are covered. Serving both commercial insurance and Health First Colorado means you can serve families with mixed health insurance coverage (e.g. Dental benefits, 3. Improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado. No co-pays if determined an emergency; $8 per visit if not emergency. We are the regional organization for Adams, Arapahoe, Denver, Douglas, and Elbert counties. Call the Department of Human Services Office of Behavioral Health at 303-866-7400to find a provider in your area. Visit colorado.gov/PEAK to update your details now. *If you received a letter from Health Care Policy and Financing entitled Update on benefit termination and have questions about Health First Colorado or CHP+ benefits or billing, please call the Member Contact Center at 1-800-221-3943 (State Relay: 711) Monday-Friday from 8:00 a.m. to 4:30 p.m. When you call the Nurse Advice Line you will always reach a live person who is ready to answer your medical questions. Explore programs for children, pregnant women, parents & caretakers, and adults. TTY: 1-800-659-3656 Covers supplies. Benefits that will be impacted in the coming weeks and months include the Supplemental Nutrition Assistance Program (SNAP food benefits) and Medicaid benefits. For a members acute care home health needs lasting 60 days or less, members can get all necessary services without prior authorization or approval. We support a network of providers to make sure you get can get health care. Members must be part of the telemedicine appointment. 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: If you have questions about the services Health First Coloradocovers please contact your doctor or the Member Contact Center. If you are denied Health First Colorado coverage, you may be eligible for other health care programs. Hospitalization Health First Colorado Member Handbook, Spanish Version Womens health services. Its always a good idea to discuss your physical and behavioral health needs with your PCP. Children may qualify for rehabilitative and Habilitative therapy. 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. Whats covered? Physical and Occupational therapies provided in the office, clinic, or outpatient hospital setting, Inpatient Physical therapy/ Occupational therapy, Lab and radiology test such as x-rays and blood work. With Health First Colorado, you belong to a regional organization. children on Health First Colorado and parents on private coverage). Call your health care providers office for an appointment or to refill your medications. You never have to pay more than the co-pay for covered services. Coverage includes the device, insertion, removal and re-insertion at any time. Some pregnant people might also be able to get these services. Outpatient surgery that takes place at an Ambulatory Surgery Center, Outpatient hospital services that do not require you to be admitted to the hospital, Inpatient Medical or Surgical Care that requires you to be admitted to the hospital. Forms. People who receive Old Age Pension (OAP) grants who do not qualify for other Health First Colorado programs. Copyright 2023 Carelon. Buildings are closed on Friday, butonline services are available. Radiation therapy and Chemotherapy services, $4 if performed in an outpatient hospital, Prenatal and postpartum care and provider visits before and after a patients baby is born. If you believe you are eligible for benefits through Health First Colorado or CHP+, you should reapply to find out. Providers Providers: Authorizations Share Certain items and services require prior authorization (pre-certification) to evaluate medical necessity and eligibility for coverage. Some services may require prior authorization or approval from Health First Colorado. Emergency room visits Private duty nursing is limited to 16 hours a day for adults. 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. Colorado's Accountable Care Collaborative (ACC) Program - Primary care practices that enroll as Primary Care Medical Providers (PCMPs) in the ACC receive practice support, member-level health data, and help coordinating both medical and non-medical care for their members. Telemedicine Pregnant members can be in the program for their whole pregnancy plus 60 days after giving birth. For more information visit Health First Colorado. You should get a wellness visit each year. Prior authorization is not required for emergency ambulance services. Can they still help me? Nurse Home Visitor Program for first time mothers. Billing Manuals. 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. Yes. Health First Colorado coverage gives you 3 kinds of basic benefits: 1. Home health Available only to clients 21 years of age and older regardless of gender. Map & Directions 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. Your benefits include both mental health and substance use care services. Members are protected under the Federal Mental Health Parity and Addiction Equity Act (MHPAEA). We help healthcare providers advance safety and operational efficiency through smart automation. For more information on COVID-19, please visit coaccess.com/covid19. Learn More & Apply Find Doctors & Other Providers Search for Health First Colorado doctors and other providers by location, name, or specialty. This program provides limited medical care only. Please keep in mind that some benefits may need prior authorization. This includes preventive services, like a wellness visit. Here are some of the services covered under your benefits: Allergy tests and shots 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. The normal Medicaid renewal process is starting in May. For resources, see the Community Resources Page. If one or more household members do not automatically renew for Health First Colorado, you will need to take action on your Medicaid renewal. No co-pay in therapy clinic or rehab agency. Non-generic drugs are given only with. Healthfirst Provider Services 1-888-801-1660. When you visit one of our hospitals and facilities, we want you to feel at ease and excited for the next step in your wellness adventure. Immunizations and vaccines such as influenza, chicken pox, measles and others. Boulder County offices will be closed Monday, July 3, and Tuesday, July 4, in observance of Independence Day. From choosing baby's name to helping a teenager choose a college, you'll make . VIDEO: How to update mailing address and communication preferences online English | Spanish. If you have Health First Colorado (Colorados Medicaid Program): Please visit healthfirstcolorado.com/covid for the most up-to-date benefit information. Talk to your primary care provider or regional organization. Additional family planning follow-up visits and services are covered when medically necessary. Well Care for Children and Youth (EPSDT Services). No co-pays for anyone 19 or younger; no co-pays for pregnant members. Family planning office visits and counseling services focused on preventing, delaying or planning for a pregnancy. These services are examples of benefits that may be available to you and your family. While the name and look have changed, member eligibility, benefits, and choice of providers will remain the same. Your benefits include any type of care for your body. 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. For brand name or generic medicines, adults pay $3 per prescription or refill. As a Health First Colorado provider, you have full control of the number of Health First Colorado patients you see. 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. See the current Authorization List to determine if prior authorization is required for general categories of services. If you need nursing home or home and community based services (HCBS), please see below for information about Long-term Care Medicaid. 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. Dental benefits, 3. For members long term home health needs, you must get prior authorization or approval. Breast pumps must be provided by an approved supplier, which are often pharmacies. Caring for you and your health is our top priority. 12-month supply of oral pill, vaginal ring, or topical contraceptives. Adult vision care benefit includes medically necessary eye exams, glasses and contact lenses only after surgery. 900 Jefferson County ParkwayGolden, CO 80401Phone: 303-271-1388Toll Free: 888-256-0321Email Us. They can answer your questions or help direct you to a hospital in your area. Pregnant members may receive a pump as early as the 28th week of pregnancy. Immediate postpartum LARC insertion is covered. There is no limit on private duty nursing for children up to their 21st birthday. Boulder, CO 80306, Fax: 720-564-2283 Pregnant and parenting members do not have to pay co-pays. There are several different programs. Procedure may be provided 30 days after informed consent, but within 180 days. Primary Care Learn more about finding a primary care provider and how they can help keep you healthy. Member Contact Center1-800-221-3943/State Relay: 711. No limits for children. Limited to women age 40 and older and for younger women who are high risk. For more information on COVID-19, please visit. Get more information about your benefits by contacting your primary care provider, regional organization, or the Member Contact Center. Requires a prescription from a doctor or a pharmacist. Here are some of the behavioral health benefits you have: Alcohol/drug screening counseling The nurses know about hospitals all over Colorado, as well as other resources you might need. Private Duty Nurse who provides one-on-one care to patients. Talk to your provider for more information. Improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado. Hospice 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. Your age, family size, income and other information asked for in the application are used to ensure you are enrolled in the program that best meets your needs. Call 303-441-1000 or email, Housing & Human Services, 515 Coffman Street, Longmont, CO 80501. Learn more about finding a primary care provider and how they can help keep you healthy. We have a network of providers to make sure you can get care in a coordinated way. Postpartum members may receive a pump at any time. For more information regarding your overall healthcare talk to your primary care provider or regional organization. Call 800-283-3221 to: Any Health First Colorado member can call the Nurse Advice Line for help. No ear molds for swimming/noise reduction. Connect for Health Colorado is a new online health insurance marketplace that opened on October 1, 2013. Yes. Get access to helpful resources including patient portals, financial assistance, charge masters . John Lewis submits plans to build first of 10,000 homes The retailer might be best known for its homeware and fashion products, but it has just submitted plans to build almost 1,000 homes in . Long-term home health therapies Preventive and wellness services and chronic disease management such as aspirin use, blood pressure screening, breast cancer screening, cholesterol screening, depression screening, healthy diet counseling, sexually transmitted disease prevention counseling, tobacco use screening and counseling and others. Claims are paid weekly and deposited directly into your business account. In Colorado, Medicaid is called Health First Colorado. LEARN MORE OnTraq: Automating Safety and Efficiency through Smart Automation You do everything to protect your children. Supplemental Nutrition Assistance Program, Learn how to apply for Health First Colorado. If you have children, your kids may qualify for more benefits and services. Services include cleanings, fillings, root canals, crowns, and partial dentures. Health First Colorado is public health insurance for low-income Coloradans who qualify. You can choose whether your practice is published in our online Provider Directory. $10 per covered day or 50% of the averaged allowable daily rate, whichever is less. Providers - Colorado Access. People Age 65 and Over: People age 65 or older who are eligible for Supplemental Security Income (SSI) and/or Old Age Pension (OAP) state supplemental payments are eligible for Health First Colorado. Agencies. Case management Children under age of 19 and pregnant members do not have co-pays. This packet can be completed by mail, dropped off in person, online or over the phone. Health First Colorado Manual del miembro en Espaol. There are several ways to apply for benefits. They can also connect you to resources you may need. Have health insurance questions or need an affordable, quality health plan? P.O. Hours: 8:00 AM - 4:30 PM - Monday/Wednesday/Friday, 515 Coffman Street Health Care Policy & Financing. The call is always free! Dont worry if you need help to figure out what you need or how to get it. $2 per visit if not part of an emergency room. Habilitative therapies may be available. What happens next? Covers Cochlear implants for only ages 20 and under, replacement when current unit is broken/non-functional. No co-pay for telemedicine but co-pays may apply for other services provided. Detox 303-866-2993 303-866-4411 1570 Grant Street Denver, CO 80203 Should I use the Nurse Advice Line if I have a question about my condition or medications? This means both primary care providers and behavioral health providers. If you no longer qualify because you missed the deadline to respond, you can re-apply for Health First Colorado. Gainwell Technologies will be open. All information must be completed by the deadline provided to avoid losing coverage. I dont live in Denver. The line is staffed by nurses who can answer your health questions. Visit colorado.gov/PEAK to update your details now. Some adults qualify for Habilitative therapy. Update your address and phone number. 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. We want to make sure you stay updated on any benefit changes as a result of COVID-19. Special Connections Program is for pregnant members who struggle with alcohol and/or drug misuse. Exclusive cloud provider - As OpenAI's exclusive cloud provider, Azure will power all OpenAI workloads across research, products and API services. Yes. Should I call the Nurse Advice Line if I need help deciding if I have an urgent medical situation? Search for Health First Colorado or Child Health Plan Plus doctors, waiver services, pharmacies, and other providers. Step 1: Health First Colorado will mail the yearly renewal materials to you and/or your family members 60 days before your redetermination date. Coronavirus (COVID-19) is here in Colorado. Log in to PEAK. We also offer comprehensive mental health and substance use care services. Emergency contraceptives, including over the counter with a prescription. We would like to show you a description here but the site won't allow us. You will likely not work with us very often if you get most or all of your health care needs met by your primary care provider or behavioral health provider. If you have Health First Colorado (Colorado's Medicaid Program) or Child Health Plan Plus (CHP+), make sure they have the right contact details for you. One visit to a provider for the same issue per day. Surgical sterilization, including tubal ligation and vasectomies. Urgent care Long-acting, reversible contraceptives (LARC) such as intrauterine devices (IUDs) and implants. If you have more complex needs and get services from many state agencies, we can work with you and your different providers. Some categories will consider resources. First Name * Last Name * Phone Number * Email Address * Home Zip Code . Physical health benefits, 2. We acknowledge the painful history of genocide and forced removal from this territory, and we honor and respect the many diverse Indigenous peoples still connected to this land on which we gather. Adults limited to rehabilitative therapy only. Yes. Behavioral health (mental health and substance use benefits). You can call 7 days a week, 24 hours a day, 365 days a year. Talk to a nurse who will answer medical questions, give care advice, and help you decide if you should see a provider right away. 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 Breast pumps must be prescribed by a physician, physician assistant, or nurse practitioner. This marketplace is sometimes referred to as the health insurance exchange. Individuals, families and small employers can shop for and buy health insurance through the Connect for Health Colorado website. Ask Healthfirst. Members do not have to pay a co-pay for a screening colonoscopy but do have to pay a $2 co-pay for a diagnostic or treatment colonoscopy. 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. So when emergencies happen, your kids need world-class medical care. If you feel these rights have not been upheld, you can call the Behavioral Health Ombudsman at 303-866-2789, Email them at: ombuds@bhoco.org, 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. This act states that there are not more limits on your behavioral health benefits than your physical health benefits. Our preparedness, prevention and compliance solutions offer cloud-based monitoring, reporting, and on-time replenishment for added peace of mind.