Provider Handbook
The ValueOptions® Colorado Medicaid Provider Handbook serves as a supplement to the ValueOptions® Participating Provider Handbook and provides a quick reference guide about policies and procedures specifically related to NBH Partnership.
- Welcome
- General Information
- Colorado Medicaid BHOs
- Clinical Services Descriptions
Provider Assistance & Referrals
- Clinical Operations
- Customer Service Department
- Network Credentialing
- TeleConnect and ProviderConnect
- Provider Availability and Access to Care Standards
- Referrals
- How Clients Access Behavioral Health Care
Utilization Management Procedures
- Overview
- Care Management Functions
- Authorizations
- Medical Record Requirements
- Advanced Directives
- API Tools and Suggestions PDF
- Psychological Testing Evaluation Form
- Member Choice
- Second Opinions in a Disagreement with Treating Provider
- Second Opinions in a Disagreement with a Notice of Action
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program
- Case Managers
- Care Providers
- How to Access EPSDT Services
- Provider Responsibilities
- Getting Member’s a PCP
- Coordination with Other Agencies
Reviews, Reconsiderations and Appeals
- Contacting Member and Family Affairs for Assistance
- Clinical Guidelines
- Peer Reviews
- Requesting Reconsideration
- Retrospective Authorization Process
- Member’s Request for Appeal of an Action
- Member’s Request for a State Fair Hearing
- Continuing Services
- Definitions
- Designated Client Request Form
- Credentialing and Recredentialing Standards
- Contract Requirements
- Credentialing Committees
- Termination, Sanctions and Appeals
- Change of address form
- Colorado Medicaid Exclusions
- Benefit Limits
Colorado Client Assessment Client Record (CCAR)
- CCAR Requirements
- CCAR Form Example
- CCAR Website Link
- Pre-CCAR Client Form for Provider Use
- Billing for Services
- Electronic Claims Submission
- Claims Appeals
- Colorado Medicaid Adjustment Form
- Covered Diagnoses
- Explanation of Payment Codes
- Program Integrity
- Adverse Incidents
- Provider Quality Improvement Program
- Quality of Care
- Treatment Record Audits
- Confidentiality
- Adverse Incident Form
Office of Member and Family Affairs
- General Information
- Member and Family Input
- Cultural Competency
- Grievances and Appeals of Actions
- Compliments
- Ombudsman Flier in English
- Ombudsman Flier in Spanish
- Member Rights Poster – English
- Member Rights Poster - Spanish
- Making Transportation Arrangements
NBHP Specific Contract Requirements (Coming Soon)
- General Requirements
- Service/Treatment Plans
- Progress Notes
Treatment Systems Level of Care and Diagnosis-Based Treatment Guidelines
Sample Clinical Forms
