Colorado Department of Health Care Policy and Financing Forms

This document provides instructions for the Federally Qualified Health Center (FQHC) Managed Care Accuracy Audit Report in Colorado. It guides FQHCs on how to accurately complete the audit report.

This document is an accuracy audit report for a Federally Qualified Health Center (FQHC) in Colorado. It attests to the compliance and accuracy of managed care services provided by the FQHC.

This document is a Managed Care Accuracy Audit Report for a Federally Qualified Health Center in Colorado. It includes an MCE Attestation Statement to ensure accuracy in managed care services.

This Form is used for physicians in Colorado to provide a statement regarding a patient's life-limiting illness.

This Form is used for the initial screening and intake process in Colorado.

This document is used to request a review of the support level in the state of Colorado.

This form is used for determining the level of care in Colorado.

This document provides information about the length of stay in nursing facilities in Colorado. It covers the duration of time individuals typically spend in these facilities for medical or long-term care.

This form is used for quickly referring individuals with Alzheimer's or related dementia to the Colorado chapter of the Alzheimer's Association for support and resources.

This document outlines the coverage standards and provides a request form for Spinraza (Nusinersen) in the state of Colorado.

This training exercise in Colorado focuses on personal reflection and pride in the context of disability. Participants will engage in exercises to explore their own experiences with disability and discover ways to cultivate pride in themselves and others.

This form is used for obtaining prior authorization for pharmaceuticals that will be administered in an outpatient hospital setting in Colorado.

This form is used for requesting changes to prior authorizations for healthcare services in the state of Colorado.

This Form is used for requesting a fax exemption in the state of Colorado.

This form is used for requesting an exception to coverage in the state of Colorado.

This form is used for requesting auxiliary aids and services in the state of Colorado. It allows individuals to request accommodations to ensure equal access to programs and services.

This document is a questionnaire form used in Colorado for members who require oxygen based solely on a sleep study and need portable oxygen with an oxygen content exceeding 6 liters per minute.

This form is used for applying for Oxygen benefits through the Health First Colorado program in Colorado. It certifies the medical necessity of oxygen therapy for eligible individuals.

This Form is used for facilities enrolling with Health First Colorado in Colorado to provide attestation of their services and eligibility.

This Form is used for requesting a review of exceptions to Supported Living Services (SLS) in Colorado.

This form is used for applying for a rate adjustment in the scope-of-service in Colorado. It provides instructions on how to complete the application.

This document is for auditing the accuracy of managed care in Rural Health Clinics (RHC) in Colorado. It includes a reconciliation attestation statement.

This Form is used for requesting a rate adjustment for scope-of-service in rural health clinics located in Colorado. It includes an attestation statement.