Incorrect Taxonomy Code - The NPI and taxonomy code submitted with the provider’s enrollment application must match the information on record with the National Plan and Provider … We offer contracts to any willing provider who meets all requirements to service Medicaid Members as a Primary Care Provider and Medical Home in the ACC Program, this includes: Copyright © 2020 Beacon Health Options. Thank you for your interest in becoming a PCP with Beacon Health Options. The National Provider Identifier (NPI) will also continue to be included in provider enrollment letters. All providers, medical or nonmedical, who are enrolled with and bill Medicaid for services under the state plan or a waiver must be screened under rule CCR 2505-10 8.100 by enrolling. Home & Community - Based Services (certain specialties only), Psychiatric Residential Treatment Facility, Rehabilitation Agency Comprehensive Outpatient Rehabilitation Facility. If you're a current member and need to see a doctor, dentist, or other medical provider please see our Find a Doctor page. Provider Search Results. If an enrolled individual with an SSN wants to change provider types, the existing enrollment needs to be disenrolled, the affiliations ended and a new application completed. The Enrollment Type categorizes provider types to help identify additional enrollment requirements. Once the update is submitted, providers must call the Provider Services Call Center at 1-844-235-2387 to request the change from OPR to IWG. Providers may affiliate via the group profile through the Provider Web Portal, or the individual will have access to make the affiliation after the enrollment type change is made. The average processing time is 5-10 business days. Before the enrollment type can be updated from OPR to IWG, providers must update their license. In accordance with federal screening rule 42 CFR § 455.104 and Colorado Code of Regulations 10 CCR 2505-10 8.125.15, a verification is completed for all individuals and when the DOB does not match, the application is returned to the provider for correction(s) or denied. For more detail, contact Colorado Access or the provider. Once the public health emergency designation is lifted, no new temporary enrollment applications will be approved. Incomplete information will result in a delayed response. Synagis is covered for eligible patients through the Colorado Access pharmacy benefit. Find out if you qualify and how to easily apply for Health First Colorado, Colorado's Medicaid Program. Refer to the Updating an Electronic Funds Transfer (EFT) Provider Web Portal Quick Guide located on the Quick Guides web page. New applicants will be required to indicate temporary enrollment due to the public health emergency or long term enrollment. For example, a Pharmacy only has the option to enroll as a facility, while a Physician may enroll as either a Billing Individual, an Individual Within a Group, or an Ordering-Prescribing-Referring (OPR) Provider. Please send us the following information for each practitioner and facility that would like to be credentialed with us. Providers are encouraged to review the information below for faster approval. IMPORTANT: OPR providers are only allowed to order, prescribe, or make referrals. Prior to any temporary enrollments being terminated, providers will be notified and given the opportunity to convert from temporary enrollment to long term enrollment by updating the application and completing the requirements. 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: Early and Periodic Screening, Diagnostic, and Treatment, Screening Brief Intervention & Referral To Treatment,
[email protected], Be enrolled as a provider in the Colorado Medicaid program, Certified by the state as provider in the Medicaid and CHP+ Medical Homes for Children program, Individual physician, advanced practice nurse or physician assistant with a focus on primary care, general practice, internal medicine, family medicine, pediatrics, geriatrics, or obstetrics and gynecology, or is a qualified CMHC or HIV/infectious disease practitioner or, A federally qualified Health Center (FQHC) or Rural Health Clinic (RHC). The Affidavit of Lawful Presence form is available on the Provider Forms web page under the Provider Enrollment & Update Forms drop-down section. Upon prior authorization approval, Navitus will notify Avella, who will fax a home health request to set up the services. The application is reviewed by the Department's fiscal agent. If you are interested in contracting with Colorado Access please complete a Provider Contract Appendix and return it along with copies of your W-9 and proof of Professional Liability Insurance coverage and send them to our provider contracting team at provider… Submitting an OPR application with the same Social Security Number (SSN) as a previously enrolled IWG may result in the application being denied as a duplicate or in denied claims. Providers are reminded to enter the actual DOB for individuals, owners and managing employees, in the appropriate sections of the enrollment application (Provider Identification and Disclosures). As the Administrative Service Organization for Health Colorado (Region 4) joining the Beacon network will allow you to serve Health First Colorado Members throughout the region. Effective July 4, 2019, provider enrollment letters will now include the Health First Colorado ID. Need to speak to a live agent for help with your enrollment? Physical Therapist, Podiatrist, Psychologist) cannot be changed. This is necessary because the validity and currency of all provider licenses to perform any service must be screened. We are currently adding new providers to our networks. Download and Print PDF . Member Handbook. Medicaid Provider Location ID (aka Billing ID) per service location. In addition to selecting a provider type and primary specialty, each applying provider will need to add one of the following secondary specialties to their application: This applies only to provider types for which application fees, fingerprinting and/or site visits are required, including: For providers choosing to enroll temporarily: The Affordable Care Act (ACA) requires certain providers to remit an application fee. An additional application for any of these individual types with the same SSN and same NPI as a previous application (regardless of whether the individual type is the same as on the previous application) may result in the application being denied as a duplicate or denied claims. Our utilization management team will work to set up a home health agency to visit the patient’s home and administer the medication. What happens next? All rights reserved. If you wish to have a home health agency administer Synagis to your patient, please indicate that the medication will be shipped to the patient’s home.