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Videos Inpatient Access Forms Forms and Downloads eQSuite® User Guides Provider Manuals Education and Training Resources Provider Resources eQSuite® Guides Forms and Instructions Frequently Asked Questions Lack of Information (LOI) Denials Peer-to-Peer (P2P) Consultation Process IT Requirements Reconsideration Process PAR Revision Process Supporting Documentation Retroactive PAR Policy Nurse Advice Line Provider Education/Training Presentations & Video Tutorials Training Registration Audiology Molecular Testing Behavioral Therapy Diagnostic Imaging Durable Medical Equipment Out of State Providers Long Term Support Services Medical (transplant and bariatric surgery) Pediatric Long Term Home Health Outpatient Therapy Private Duty Nursing Synagis® Vision PASRR Par’d Surgical Procedures PAR Portal/eQSuite® New to eQSuite® Minimum IT System Requirements Contact UsMission, Vision and Values Physician Reviewers Holiday Schedule Career Opportunities State News and Resources 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: https://www.colorado.gov/hcpf/dme-o2 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: How to submit a PAR Date Span Adjustment 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 Click Here 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 HCPF Provider Bulletin PAR Portal Login eQSuite Training PAR Letters Medicaid Portal Fee Schedule 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 Click for InfoCopyright 2015 by eQHealth Solutions | Privacy Statement | Terms Of Use | Login | Home | Videos | Inpatient | Provider Resources | Provider Education/Training | Par’d Surgical Procedures | PAR Portal/eQSuite® | Contact Us | State News and...