On March 1, 2017, Hewlett Packard Enterprises (HPE) will assume fiscal agent operations on behalf of Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+). These operations include the transition to the Colorado interChange (a new claims payment system) and a new provider Web Portal.
You must be enrolled in the new Colorado interChange. All providers must be enrolled (and approved) in the Colorado interChange system by March 1, 2017. Those who are not enrolled and approved will not be able to submit claims or receive payments. Visit Colorado.gov/HCPF/Provider-Enrollment for more information.
All ordering, prescribing, or referring (OPR) providers must be enrolled in the new Colorado interChange. The Affordable Care Act (ACA) now requires physicians and other eligible practitioners to enroll in the Medicaid program to order, prescribe, and refer items or services for Medicaid members, even when they do not submit claims to Medicaid. Claims listing an OPR provider that is not enrolled cannot be paid. Visit Colorado.gov/HCPF/OPR for more information.
Clearinghouse Enrollment & Testing
If you utilize a Clearinghouse to submit batch claims or eligibility transactions, your Clearinghouse MUST apply for an interChange Trading Partner ID (TPID) and pass test transactions for HIPAA compliance. Clearinghouses without an interChange TPID will not be able to submit batch claims or receive reports beginning March 1, 2017.
Please check this list to see if your Clearinghouse has enrolled and passed testing. If your Clearinghouse has not started or has not completed their testing, we recommend that you reach out and remind them to do so immediately. Your Clearinghouse can learn more information about applying for a new TPID at: Colorado.gov/HCPF/EDI-support.
If you need assistance with your revalidation or enrollment application, please call the Health First Colorado Enrollment and Revalidation Information Center at: 1-844-235-2387. Standard operating hours are 8am – 5pm MT, Monday – Friday.
Please Note: For billing, claims and Provider ID questions regarding the current Xerox system, please continue to call Xerox State Healthcare at: 1-800-237-0757.
This article originally posted on Colorado.gov.