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Starting July 1, 2025, Colorado Access is preparing to serve the new Regional Accountable Entity (RAE) Region 4, including Adams, Arapahoe, Denver, and Douglas counties, under the Accountable Care Collaborative (ACC) Phase III.
Learn more here

Provider Toolkit

We want you to have the resources you need. Find the new Provider Portal, fee schedule and more.

Provider Tools

Provider Portal: The new portal for claims, eligibility, behavioral care fee schedule and more.

Portal Training: For any questions about the new portal including registration, sign in, reporting and more, please start here.

Clinical Update Form Training: For any questions about how to complete and submit requests to add a provider, term a provider, report a clinic closure, submit a roster, etc, please start here. A list of recorded trainings is also available here.

State Behavioral Health Services Billing Manual: A living document that is frequently updated as coding, state, and federal regulations change. The manual can be found under the State Behavioral Health Services Billing Manual.

Authorization Requests

We strive to make the prior-authorization process as easy as possible for you. The following is a summary of our authorization rules and does not guarantee coverage. You can find additional information in the:

• Authorization List (no login required)
• Provider Manual
• Prior Authorization

Provider Frequently Asked Questions

How do I get Synagis for my patients?

Complete Synagis prior authorization form and fax to Navitus at 855-668-8551. You will receive a fax indicating approval or denial of prior authorization determination is made. If request is approved, fax order for Synagis to Lumicera Specialty Pharmacy at 855-847-3558. If you wish to have a home health agency administer Synagis to your patient, please indicate that the medication will be shipped to the patient’s home on your order. Upon receipt of Synagis order indicating that medication will be shipped to patient’s home, Lumicera will fax a home health request to Colorado Access utilization management (UM) team to set up the services. Our UM team will work to set up a home health agency to visit the patient’s home and administer the medication.

Is Synagis covered by Colorado Access?

Synagis is covered for eligible patients through the Colorado Access pharmacy benefit. The specific criteria for approval can be found here. Prior authorization forms should be faxed to Navitus at 855-668-8551.