Provider Handbook

Colorado Health Partnerships (CHP) Provider Handbook Supplement

The Beacon Health Options Colorado Medicaid Provider Handbook serves as a supplement to the Beacon Health Options 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)

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
  • Integration of Primary Care and Behavioral Health
  • 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
  • Designated Client Request Form

Section X: Network Credentialing (PDF)

Section XI: Benefits Summary (PDF)

Section XII: Colorado Client Assessment Client Record (CCAR) (PDF)

Section XIII: Billing for Services (PDF)

Section XIV: Quality Improvement (PDF)

Section XV: Office of Member and Family Affairs (PDF)

Section XVI: Transportation (PDF)

  • Making Transportation Arrangements

Section XVII: Documentation Standards (PDF)

  • General Requirements
  • Service/Treatment Plan Development
  • Progress Notes

Section XVIII: Compliance and Program Integrity (PDF)

  • Compliance and Anti-Fraud Plan
  • Confidentiality, Privacy & Security