Colorado Health Partnerships (CHP) Provider Handbook Supplement
The ValueOptions® Colorado Medicaid Provider Handbook serves as a supplement to the ValueOptions® Participating Provider Handbook and provides a quick reference guide about policies and procedures specifically related to Colorado Health Partnerships.
Section I: Introduction (PDF)
- Welcome
- General Information
- Colorado Medicaid BHOs
Section II: Continuum of Services (PDF)
- Clinical Services Descriptions
Section III: Provider Assistance & Referrals (PDF)
- Clinical Operations
- Customer Service Department
- Network Credentialing
- Tele-Connect and ProviderConnect
- Provider Availability and Access to Care Standards
- Referrals
- How Clients Access Behavioral Health Care
Section IV: Utilization Management Procedures (PDF)
- Overview
- Care Management Functions
- Authorizations
- Medical Record Requirements
- Advanced Directives
- Psychological Testing Evaluation Form
Section V: Client Choice of Providers (PDF)
- Member Choice
Section VI: Second Opinion (PDF)
- Second Opinions in a Disagreement with Treating Provider
- Second Opinions in a Disagreement with a Notice of Action
Section VII: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program (PDF)
- Case Managers
- Care Providers
- How to Access EPSDT Services
Section VIII: Coordination of Care (PDF)
- Provider Responsibilities
- Getting Member’s a PCP
- Coordination with Other Agencies
Section IX: Reviews, Reconsiderations and Appeals (PDF)
- Contacting Member and Family Affairs for Assistance
- Clinical Guidelines
- Peer Reviews
- Requesting Reconsideration
- Retrospective Authorization Process
- Member’s Request for Appeal of an Action
- Member’s Request for a State Fair Hearing
- Continuing Services
- Definitions
Section X: Network Credentialing (PDF)
- Credentialing and Recredentialing Standards
- Contract Requirements
- Credentialing Committees
- Termination, Sanctions and Appeals
- Change of Address Form
Section XI: Benefits Summary (PDF)
- Colorado Medicaid Exclusions
- Benefit Limits
Section XII: Colorado Client Assessment Client Record (CCAR) (PDF)
- CCAR Requirements
- CCAR Form Example
- CCAR Website Link
Section XIII: Billing for Services (PDF)
- Billing for Services
- Electronic Claims Submission
- Claims Appeals
- Colorado Medicaid Adjustment Form (PDF)
- Covered Diagnoses (PDF)
Section XIV: Quality Improvement (PDF)
- Program Integrity
- Adverse Incidents
- Provider Quality Improvement Program
- Quality of Care
- Treatment Record Audits
- Confidentiality
- Adverse Incident Form (PDF)
Section XV: Office of Consumer and Family Affairs (PDF)
- General Information
- Member and Family Input
- Cultural Competency
- Grievances and Appeals of Actions
- Compliments
- Ombudsman Flier in English (PDF)
- Ombudsman Flier in Spanish (PDF)
- Member Rights Poster (PDF)
Section XVI: Transportation (PDF)
- Making Transportation Arrangements
Section XVII: CHP Specific Contract Requirements (Coming Soon)
Section XVIII: Community Mental Health Center Sites (PDF)
Section XIX: Documentation Standards (PDF)
- General Requirements
- Service/Treatment Plans
- Progress Notes
Treatment Systems Level of Care and Diagnosis-Based Treatment Guidelines
Sample Clinical Forms