In The News

Medicaid interchange Milestones and Initiatives 

Posted: June 2, 2017

HCPF reported on May 25th that the work to modernize the Medicaid provider payment system is proceeding and resources have been added to improve call wait times as well as training to help call center staff resolve issues on the first phone call, whenever possible.

HCPF reminds providers that the quickest path to resolution of individual provider issues continues to be the Health First Colorado Provider Call Center: 1-844-235-2387. HCPF says hold times have dropped dramatically since the system launch. 

Here are a few differences in messages and codes that can create confusion:

  • · Why is my claim marked "suspended"?

This is the new identification for claims that simply need further manual review. In the old system, they would have been identified as "In Process". Suspended claims are in process and HPE / DXC is working to reduce the backlog of claims by June 1st. Currently, less than 3 percent of claims fall into this category each billing cycle.

  • · I saw a suspended claim last week in my remittance advice. Why don't I see it again this week?

Suspended claims appear once on the remittance advice when they are filed and placed in the queue for additional manual review. They will only appear again when they are either paid or denied. HPE / DXC keeps the claims on file and processes them for payment as soon as they are reviewed.

  • · Why do claims now require a national drug code on medications not required before?

The Center for Medicare & Medicaid Services requires that a national drug code be collected on all drugs, even over-the-counter medications. This was not previously required. To help with these types of issues as well as processes for navigating the new system, providers should visit our web site that provides quick guides. for many common procedures

You Might Be Hearing...

Hot topics and key changes impacting providers:

The Department website continues to be the best place to find current information on known and resolved issues.

Billing from the correct account

A common reason for claim denials is filing from the wrong account. For example, some providers continue to log in with an old provider identification number that has since changed. Other providers have more than one account because they are registered as more than one provider type. If this is the issue, a simple fix is available: double-check that you are logged into and billing from the correct account. Providers can see a simple primer on how to check your log in or correct issues with it. This primer includes screen shots to make it easy to use in real time. 

Place of service codes

Some claims are denying for the explanation of benefits (EOB) code 1030. The denial states "the place of service code is invalid for procedure code". Place of service designations 11, 19 and 20 were not set up for all appropriate procedure codes. The Department is working to add a large volume of codes to allow providers to use these three designations. When this issue is resolved, providers will need to rebill affected claims. 

Denials for affiliation

Although the denial for affiliation appears on provider's remittance, this is informational only, and does not impact the claim. The Department is not denying any claims for a missing affiliation to allow providers more time to update their enrollment profiles.

You Will Be Happy to Hear...

Member eligibility in member-focused viewing has been fixed

Previously, when using the member-focused viewing option in the web portal, either no coverage details were listed or listed details contained incorrect eligibility dates. This issue has been fixed and data should now be showing correctly in the member-focused viewing. 

Resources & Direct Assistance


Conference Rates Increase On Wednesday, May 3, For 2017 Rocky Mountain Home Care, Home Health & Hospice Conference

Posted: April 28, 2017

Attendees can receive up to 12 hours for the full conference and up to 4 additional hours for attending the pre-conference towards their state licensing/administrator requirement. 

Don't Forget About The Software Demo Breakfast Thursday Morning

If you're interested in learning more about software to help you run your home health agency...please be sure to attend the software demo breakfast on Thursday morning, May 18, from 7 a.m. - 8 a.m. You'll hear from three software companies (Axxess, Brightree and Kinnser) who will give a brief demonstration of their software and answser questions.

Thanks To Our Conference Sponsors:

Crag Business Group Inc., The

Kinnser Software 


Premier Medical Corporation 

Click here to see a current list of sponsors and exhibitors.

 Donate To The Silent Auction

Proceeds benefit HCAC's programming, scholarships and outreach activities. Let us know what you will be bringing by completing this quick online form.





Members: Here's The Latest From Washington On Health-Care Reform

Posted on: April 28, 2017

Health care reform chatter is live and well again. 

Members, read an update from our national association here. Not a member? Join us. 



HCAC Welcomes The Following Agencies As New Members To The Association In 2017

  • Christian Living Communities Home Care Services
  • Good Samaritan Society - Colorado Home Care & Services at Home
  • SCL Home Health
  • Transitions Home Health Care
  • VitalCare Corporation
  • Alpine Homecare, LLC

Search for a member agency here. For a full list of 2017 member agencies, click here.


HCAC Has Members-Only Update On Overtime Law

Posted: April 25, 2017

HCAC today released a members-only update on U.S. overtime law. 

View the update (you must be a member and signed in)

Not a member? Join us today!


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