Colorado interChange: Resources for your Membership
Week of June 19, 2017
Milestones and Initiatives 
As we continue to work through the transition to Colorado's new interChange system, we know providers and their claims staff are on a sharp learning curve.  For example, they need to know how the revalidation process works, understand new formats within Remittance Advice, and learn new terms like "Suspended" rather than "In Process" for claims that need additional information.
 
To help providers work through these changes, the Department is continuing to develop Quick Guides and Frequently Asked Questions aimed at providing step-by-step, visual guidance for common issues and changes that can be confusing. Topics available include:
You Might Be Hearing...

Claims Update
Since system launch, interChange has processed nearly 12 million claims and paid more than $2.3 billion to providers. On a weekly basis, an average of 60 percent of claims are paid. In the financial week ending June 16, the Department processed 767,581 claims and paid more than $115 million or 60 percent of all claims processed during that cycle.

Current anesthesia policy reimburses claims based on fifteen minute time units where any fractional unit of service is rounded up to the next fifteen minute increment. The system is currently pricing fractional units without rounding up to the next fifteen minute increment. The Department is aware of this issue and our vendor is working on a system solution. Please continue to submit claims normally and the Department will resubmit affected claims once the issue is resolved.
 
Retroactive Updates to Eligibility Spans
A system issue is currently preventing the Colorado interChange from processing some retroactive changes to a member's eligibility span. If a member believes a fix to their eligibility information is necessary, the process is the same as it was in the old system. The member must call the Health First Colorado Member Contact Center to initiate the correction. If the member has already contacted the Member Contact Center and obtained the Proof of Insurance, the provider should accept this as eligibility verification and render services. The eligibility update will take 2 to 3 business days to appear in the system. Once the fix is made, the provider will be able to submit or resubmit claims for services to the member.   For more detailed information, please refer to this fact sheet.
 
An error is occurring when providers are attempting to change the rendering or referring provider on the service detail line of a claim after the initial entry. Currently, the portal does not save the change. Until the issue is resolved, providers need to remove and re-enter the line, if they need to change the original entry. To do this, the provider needs to remove the entry by clicking "Remove" in the "Action" column or clicking the "Reset" button at the bottom of the window. Our vendor is working to resolve this issue.
You'll be happy to know
If a provider submitted a $0 deductible on a claim and the Medicare deductible had been met, claims were incorrectly denying for EOB 3620 - "The Medicare deductible on the claim is greater than annual amount. The deductible amount must match the amount on the Medicare explanation of benefits. Correct the deductible amount." This issue has been resolved and claims will be reprocessed by our vendor. No action is needed by providers.
Help Us Help Providers
We need your help to identify struggling providers as well as ongoing issues in need of attention. Please help providers in your network get the assistance they need by connecting them to resources or direct assistance:
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