Medical billing services in Colorado
Billing, coding, credentialing and A/R follow-up for providers in Colorado.
Billing in Colorado: what is different
Health First Colorado works through regional accountable entities that coordinate care and manage behavioral health.
Key payers and contractors in Colorado
- Medicare Part A/B
- Novitas Solutions, Jurisdiction JHPortal: Novitasphere
- Medicare DME
- CGS, DME MAC Jurisdiction CDME supplier claims only · Portal: myCGS
- Medicaid
- Health First ColoradoPortal: Health First Colorado Provider Web Portal
- Blue Cross Blue Shield
- Anthem Blue Cross and Blue Shield
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with Colorado providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with Novitas Solutions through Novitasphere
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in Colorado: common questions
Do you bill Health First Colorado and its managed care plans?
Yes. We bill Health First Colorado fee-for-service claims and each Medicaid managed care plan, after confirming the patient’s assigned plan for the date of service.
Who processes Medicare claims in Colorado?
Medicare Part A and B claims in Colorado are processed by Novitas Solutions (Jurisdiction JH), and we submit and track them through Novitasphere. DME supplier claims go to a different contractor, CGS (DME MAC Jurisdiction C), through myCGS.
Can you credential new providers in Colorado?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Colorado.
Neighboring states and key payers
Get a free billing audit for your Colorado practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.