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Provider Toolkit

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

Exciting News!

We have launched a new Provider Portal to better serve our providers. The new portal replaces the current eligibility and claims lookup links on this page. You will still be able to check member eligibility and claims status but now be able to also view and print EOPs.

The link to the new portal is below along with a training that helps you through the sign up process. You will need your tax ID number and a valid claim number from the past 180 days. Signing up is quick and easy!

If you have any questions about the new provider portal, please contact your Colorado Access provider network services representative or email us at ProviderNetworkServices@coaccess.com

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.

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.