Colorado Medicaid — Health First Colorado (Colorado Medicaid)
| Program name | Health First Colorado (Colorado Medicaid) |
|---|---|
| Provider portal | https://hcpf.colorado.gov |
| FFS claims payer ID | No single canonical ID — routing is fiscal-intermediary-specific. Verify per clearinghouse. |
| Medicaid timely filing | 120 days from date of service |
The federal ceiling for Medicaid timely filing is 12 months under 42 CFR §447.45; most states set a shorter window. Always verify the current policy on the Colorado Medicaid provider portal before filing a late-billing appeal.
BCBS licensee in Colorado
The Blue Cross Blue Shield Association licensee in Colorado is Anthem Blue Cross and Blue Shield Colorado (Elevance Health). See the Anthem (Elevance Health) payer guide for payer ID, timely filing, prior auth, and appeal procedures.
Top commercial payers in Colorado
The dominant commercial insurers operating in Colorado, in approximate order of lives covered. Click through for per-payer claims payer IDs, timely filing windows, prior-authorization rules, and appeal procedures.
Medicaid MCOs in Colorado
Health First Colorado (Colorado Medicaid) contracts with the following managed-care organizations to administer Medicaid benefits in Colorado. MCO contracts dictate claims routing, prior-auth workflows, and appeal deadlines — route each claim by the member's MCO assignment, not the state FFS payer ID.
State-specific regulations affecting Colorado billing
- CRS §10-16-704 (Out-of-Network Health Care Services — balance billing law, effective 2020)
- CRS §10-16-106.5 (prompt pay — 30 days electronic clean claim)
- HB 19-1320 (hospital financial assistance / community benefit reporting)
Provider licensing & enrollment in Colorado
Providers enroll via Colorado interChange Provider Web Portal (Gainwell). RAEs credential separately using CAQH ProView.
Major health systems headquartered in Colorado
| Health system | Headquarters |
|---|---|
| UCHealth | Aurora, CO |
| HealthONE (HCA) | Denver, CO |
| Centura Health (Intermountain / CommonSpirit) | Centennial, CO |
| Denver Health and Hospital Authority | Denver, CO |
| Banner Health (Northern Colorado) | Greeley, CO |
Frequently asked questions — Colorado billing
What is the Colorado Medicaid program called?
Colorado's Medicaid program is known as Health First Colorado (Colorado Medicaid). Providers enroll and manage claims through the provider portal at https://hcpf.colorado.gov.
What is the Colorado Medicaid timely filing limit?
Health First Colorado (Colorado Medicaid) requires initial claims to be filed within 120 days from the date of service. The federal ceiling is 12 months under 42 CFR §447.45; Colorado's 120-day window is set by the state provider manual. Late-billing exceptions may be allowed with good-cause documentation — verify on the state portal before filing an appeal.
Does Colorado Medicaid publish a single claims payer ID?
No single canonical claims payer ID is published for Health First Colorado (Colorado Medicaid). Claims route through the state's fiscal intermediary; look up the correct submitter ID in your clearinghouse directory (Availity, Change Healthcare/Optum, Waystar) and route managed-care claims by the member's MCO assignment.
Who are the largest commercial insurers in Colorado?
The dominant commercial payers in Colorado include Anthem (Elevance Health), Kaiser Permanente, UnitedHealthcare, Cigna, Aetna, along with the BCBS licensee Anthem Blue Cross and Blue Shield Colorado (Elevance Health). Each payer's claims routing, timely filing, and prior-auth rules differ — see the per-payer guides linked above.
What Medicaid managed-care organizations operate in Colorado?
Health First Colorado (Colorado Medicaid) contracts with 2 Medicaid MCOs tracked in the QuickIntell registry, including UnitedHealthcare, Anthem (Elevance Health). MCO contracts determine claims routing and appeal deadlines — route each claim by the member's MCO assignment, not by the FFS payer ID.
What state-specific billing regulations apply in Colorado?
Colorado has 3 tracked state-level statutes that affect medical billing and RCM: CRS §10-16-704 (Out-of-Network Health Care Services — balance billing law, effective 2020); CRS §10-16-106.5 (prompt pay — 30 days electronic clean claim); HB 19-1320 (hospital financial assistance / community benefit reporting). These sit on top of federal protections such as the No Surprises Act, HIPAA, and 42 CFR §447.45.
Run cleaner claims in Colorado with QuickIntell
QuickRCM, QuickAuth, and QuickERA are tuned to Health First Colorado (Colorado Medicaid) and the commercial payers on this page — eligibility, prior auth, claim scrubbing, and ERA posting all run on real payer rules, not generic adapters.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. State Medicaid policies, MCO contracts, and payer rules change without notice — always verify against the current provider manual from Colorado Medicaid and the member ID card before submission.