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Provider Toolkit

We want you to have the resources you need. Find the new Provider Portal, CCAR, 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 relations representative or email us at ProviderRelations@coaccess.com

New Provider Portal

Provider Portal: The new portal for claims, eligibility and more.

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

Provider Tools

Behavioral Care Fee Schedule: View the standard reimbursement rate

Uniform Service Coding Standards Manual (USCSM): A living document that is frequently updated as coding, state, and federal regulations change. The manual can be found under the Uniform Service Coding Standards heading.

CCAR (Colorado Client Assessment Record): Complete this state-required form for all members receiving mental health treatment. No longer required by Colorado Department of Health Care Policy & Financing (HCPF)

CCAR Manual: Read the current 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

Legacy Provider Tools

Eligibility: Find out if a member is currently eligible

Claim Status: Check the status of your recent claim submission

Provider Frequently Asked Questions

How do I get Synagis for my patients?

Complete prior authorization forms and fax them to Navitus at 855-668-8551. All approved Synagis requests will be dispensed by Avella Specialty Pharmacy. 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. Upon prior authorization approval, Navitus will notify Avella, who will fax a home health request to set up the services. Our utilization management 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.