Quality

Appointment Standards

If you are not able to find an appointment within these time frames, please call customer service for help. You also have the right to file a grievance.

Access to Care Standards

Participating CHP+ providers are responsible for providing preventive health services, including immunizations, acute care, well visits, and risk assessments to identify members with chronic or high-risk illnesses, disabilities, or the potential for such conditions, and assessing immunization status to help ensure members receive recommended vaccinations in accordance with current state and federal guidelines. Colorado Access supports providers by communicating vaccination requirements and available resources through provider bulletins, training materials, and Provider Network Services communications.

View Access to Care Standards for Medicaid & CHP+ here.

Complaints

You have a right to complain. This may also be called a grievance. You can complain if you are unhappy with your service or think you were treated unfairly. Talk to your provider first. You cannot lose your coverage for filing a complaint.

Please let us know if you are unhappy with your providers, services or decisions made about your treatment. An example of a grievance is if the receptionist was rude to you or you couldn’t get an appointment when you needed one. For details on how to file a grievance and what to expect after you file a grievance, please click here.

Appeals

You also have a right to appeal. This means you can ask for review of an action or decision about what services you get. You will not lose your benefits if you file an appeal. You may file an appeal if we deny or limit a type of service you request. You can appeal if we reduce or stop a service that was previously approved. You can also appeal if we deny payment for any part of a service. There are other actions you may appeal. To learn about those actions and how the appeal process works, please click here.