Welcome to the Colorado Provider website!

Attention All Providers

Effective April 1, 2020, the Inpatient Hospital Review Program (IHRP) was suspended due to the Public Health Emergency related to COVID-19 pandemic. 
The following information remains in effect: Inpatient claims in which the admit date occurs on or after April 1, 2020, will not require an IHRP prior authorization, concurrent or complex case review, or Neonatal Intensive Care Unit (NICU) admission review until further notice. 
Please note the only requests requiring prior authorization related to Inpatient stays are the following:

1. Transplant requests
2. Requests with admit dates preceding 4/1/20
3. Out of State inpatient requests


This is a reminder that requirement for Prior Authorization Requests (PARs)  are currently suspended for Pediatric Long-Term Home Health and Private Duty Nursing as of July 1, 2020. The Department has decided that the PAR requirement will resume no sooner than March 1, 2021. The Department will be completing a phased in implementation and will provide sufficient notice about when PARs will be required and how the requirement will be implemented. Additional communications for members, providers, and other stakeholders will be forthcoming.
Please note:  PARs do not need to be submitted to the Department's Utilization Management (UM) vendor, eQHealth Solutions for dates of service beginning July 1, 2020. Any updates will be noticed via the Provider Bulletins, the ColoradoPAR Program website, and the Departments project website. The Department's project website contains information about the provider including action steps, communication, and trainings.    



Wildfire Evacuations


"If a member is affected by the wildfire evacuations and you need to modify a PAR, submit a change of provider form,or submit a new PAR for DME, supplies or a service please review these materials and also note on your submission that this is due to the Colorado wildfires. Additionally please mark any PARs as urgent due to this issue as appropriate."

For information on how to submit an urgent request, click here

COVID-19 RESPONSE - DME RULE 8.590.2.M

To ease provider burden during
the COVID-19 pandemic, the
Department will not be pending or
technically denying DME Rule 8.590.2.M
starting June 1st, 2020.
COVID-19 RESPONSE - DME PAR REQUIREMENTS
Effective April 3, 2020, Health First Colorado
is waiving prior authorization requirements
for oxygen therapy, positive airway pressure
devices, respiratory assist devices, ventilators,
suction devices, nebulizers and oxygen related
supplies that are emergently provided
for COVID-19 treatment.
Please click here for more information:
COVID-19 RESPONSE 
If you have a previously approved PAR that needs
to be cancelled or rescheduled due to COVID-19
and the guidance from CMS and Governor Polis, 
you may request a date span
adjustment of PAR Dates.
Please click here:  
 

INPATIENT HOSPITAL REVIEW PROGRAM SUSPENSION

Effective April 1, 2020, the Inpatient Hospital Review Program (IHRP) will be suspended to allow hospitals to direct resources to their 
COVID-19 response.  
Inpatient claims in which the admit date occurs on or after April 1, 2020, will not require an IHRP prior authorization, concurrent or complex case review, or Neonatal Intensive Care Unit (NICU) admission review until further notice.

The New 2020 Therapy HCPCS codes have been added to eQSuite®
Click on the below link for details


The Identified issue regarding Emergency Surgical Procedures requiring a PAR for claims processing was resolved as of 12/24/2019 and claims were reprocessed as of 12/20/2019. Claims denied for no PAR with date of service 4/1/2019 – 12/23/2019 will be reprocessed automatically. A PAR is no longer required for emergency procedures to ensure claim payment.
    
 

QUICK RESOURCES  

 

 
PAR Program Provider Bulletins

 HCPF Provider Bulletin
   

         

PAR Portal/eQSuite

PAR Portal Login

        

PAR Training Opportunities

eQSuite Training

             
 

 PAR Letters/IDs
  
PAR Letters
Medicaid Portal

  

  Fee Schedule   

Fee Schedule 

  

 Billing Manuals

Billing Manuals
             
 

 

eQHealth Solutions is pleased to be selected by the Colorado Department of Health Care Policy and Financing (HCPF) to provide services for the ColoradoPAR (prior authorization request) program, effective September 1, 2015. Together, eQHealth and HCPF will serve Medicaid members by focusing on and implementing HCPF’s mission to improve health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources.

The ColoradoPAR Program reviews PARs for the following services and supplies: 
   

Audiology

Behavioral Therapy

Diagnostic imaging 

Durable Medical Equipment (DME)

Habilitative Speech Therapy - Adult

Inpatient Out-Of-State Admissions 

Medical Services including Transplant and Bariatric Surgery

PASRR 

Physical & Occupational Therapy 

Pediatric Long Term Home Health (LTHH) 

Private Duty Nursing 

Synagis® 

Vision  


Please note: For the above categories, all PARs for clients age 20 and under are reviewed according to EPSDT guidelines.

ColoradoPAR does not review services for Behavioral Health Services, Dental/Orthodontia, Pharmacy, and Transportation.   Please visit the Department’s website for information for additional information on these services at https://www.colorado.gov/hcpf/provider-help







This website meets ADA compliance requirements.


 

 

 

 

 

 
    

ANNOUNCEMENTS
Upcoming Training Opportunities - Monday, January 04, 2021

All live UM trainings presented by eQHealth Solutions, Inc. are
suspended as of January 4, 2021.

Providers will still have access to the
pre-recorded eQHealth trainings
on the ColoradoPAR website
under Provider Education/Training.

Providers can request a live training
and/or 1:1 help session if needed
by sending an email to eQHealth's Provider Relations Team at:
co.pr@eqhs.com.



 
CONTACT INFORMATION

ColoradoPAR Customer Service Line
888-801-9355 (toll free phone)             

ColoradoPAR Provider Fax
eQHealth Solutions Fax Line
866-940-4288  (toll free fax)

ColoradoPAR Mailing Address 

eQHealth Solutions

Attn: Colorado Medicaid Program

5802 Benjamin Center Dr., Suite 105

Tampa, FL  33634 

Claims Questions

DXC Technology (DXC)
844-235-2387  


HCPF Main Page
https://www.colorado.gov/hcpf

 

 

 

Colorado Medicaid
Nurse Advice Line
800-283-3221

Medicaid Clients Nurse Advice Line
Click for Info