New Vendor for Prior Authorization Requests (PARs)
Effective August, 31, 2011, PARs previously sent to the Colorado Foundation for Medical Care (CFMC) should be sent to the ColoradoPAR Program
The ColoradoPAR Program, administered by APS Healthcare, is Colorado Medicaid’s new Utilization Management Program. Beginning August 31, 2011, the ColoradoPAR Program will be reviewing prior authorization requests that have previously been sent to CFMC for review. The first phase of changing to the new vendor requires that all PARs be mailed or faxed to the ColoradoPAR Program. The process and forms for submitting PARs that have been used in the past have not changed.
Please continue to send your ACS PARs to ACS for processing. At this time, the change only applies to those PARs that have been sent to CFMC in the past.
The list of PARs to be sent to the ColoradoPAR Program includes:
· Durable Medical Equipment (DME) – Limited to orthotics/prosthetics, communication devices, power wheelchairs and power scooters
· Diagnostic Imaging– limited to non-emergent Computed Tomography (CT) Scans, Magnetic Resonance Imaging (MRIs), and all Positron Emission Tomography (PET) Scans
· Medical/Surgical Services
· Reconstructive Surgery
· 2nd surgical opinions
· Physical and Occupational Therapy
· Transportation- Limited to Meals and Lodging
· Out-of-State Non-Emergency Surgical Services
· Organ Transplantation
· EPSDT Home Health
Beginning August 31, 2011, please submit the above PARs via paper to the ColoradoPAR Program’s servicing center:
The ColoradoPAR Program
C/O APS Healthcare
4545 N. Lincoln, Ste. 103
Oklahoma City, OK 73105.
Fax: 866-492-3176
The ColoradoPAR Program will have the capability for providers to submit PARs electronically in the near future. The ColoradoPAR Program will provide a new web portal with enhanced functionality to ease the administrative burden on providers for PAR submission. There will be webinars and regional trainings to assist providers with navigation and use of the new web portal. There will be additional information posted on the ColoradoPAR Web site soon regarding upcoming training schedules.
Beginning August 31, 2011, for additional assistance, please contact the ColoradoPAR Program information line at 1-888-454-7686.
If you have questions regarding this transition, please contact Erica Alikchihoo at 303-866-3385.