Menu

Referrals/Authorizations

In general, all services rendered by out-of-network (non-participating) providers require prior authorization for payment by Colorado Access. Please review the Colorado Access General Authorization rules located on our Web site at www.coaccess.com/authorizations-and-referrals for more information.

Timely Filing of Claims

The timely filing of claims is specific to line of business (or health plan).

  • For Access Behavioral Care, Colorado Access Health Plan (Medicaid), and CHP+ offered by Colorado Access (our CHP+ HMO), the timely filing deadline is 120 days.
  • For the CHP+ State Managed Care Network, the timely filing deadline is 180 days.

 

For Colorado Access Advantage (Medicare), please use the following table to determine the timely filing deadline:
Date of Service Jan Feb Mar Apr May June
Timely Filing Date Dec:31:
Service year plus one year
Dec 31:
Service year plus one year
Dec 31:
Service year plus one year
Dec 31:
Service year plus one year
Dec 31:
Service year plus one year
Dec 31:
Service year plus one year
Months to file* 23 22 21 20 19 18
Date of Service in: July Aug Sept Oct Nov Dec
Timely filing date Dec 31:
Service year plus one year
Dec 31:
Service year plus one year
Dec 31:
Service year plus one year
Dec 31:
Service year plus two years
Dec 31:
Service year plus two years
Dec 31:
Service year plus two years
Months to file*
17 16 15 26 25 24

* "Months to file" represents the number of full months plus the remainder of the service months

If you have additional questions regarding claims, please visit our Frequently Asked Questions page.

Want to Become a Colorado Access Provider?

If you would like to become a Colorado Access provider, please click here to learn more.

Have Questions? Need Help?

If you have questions please call us.

Find A Provider

 


Application Assistance

Need help applying for medical assistance?

Application Assistance

 


HIPAA One® Certified Seal

In The Community

Our Members Matter

.

Our Members Matter

Go to top