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UPDATED 10/25/19
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Provider Maintenance - Provider Web Portal Quick Guide:
Individual within a Group Provider Maintenance – Provider Web Portal Quick Guide ................. 1
Group Provider Maintenance – Provider Web Portal Quick Guide ........................................... 10
Updating Malpractice or Liability Insurance .......................................................................... 18
Individual within a Group Provider Maintenance – Provider Web Portal Quick Guide
Provider Maintenance is where a provider updates information, including:
● Provider affiliations ● Provider Specialty and additional taxonomies ● Contact information (including who gets the emails for a provider) ● Opt-out of the Provider Directory ● License and board certification information and updates ● Insurance information ● Network Participation ● Disclosure information ● ACC opt-in changes
1. Login to Provider Web Portal
2. Click Provider Maintenance
PROVIDER MAINTENANCE PROVIDER WEB PORTAL QUICK GUIDE
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3. Click Provider Maintenance again
4. Click the links on the left-hand side of the screen to jump to that area, or just click Continue
Important To-Dos for an Individual within a Group
Update the email address where we send provider related emails.
Update information for the Provider Look-up a. Opt-out of being listed in the directory
(Removal from directory listing) b. Indicate an open or closed panel Ensure Group affiliations are correct.
a. A Group’s claims will deny if the Individual’s within a Group (rendering providers) on a claim are not affiliated to the Group (the billing provider).
b. If the Group Affiliation Changes link does not show, updated affiliation information is not required.
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5. Changing an address, opting-out of being listed in the Provider Directory, or to indicate an open/closed panel
Click Address Changes, then click on the + next to the address being changed.
Opt-out of Provider Directory & changing the panel can only be done in the Service Location.
Edit the address information, check or uncheck the applicable checkboxes, & click Save.
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6. See all of the Groups an individual is affiliated to
Click Group Affiliation Changes
This Individual within a Group is not affiliated to any Groups.
To add a Group affiliation, click the + next to Click to add Group Affiliation
Missing Affiliations? Individuals w/in a Group, are only allowed to affiliate to a
Group. If affiliations are missing, it’s because they were incorrectly
affiliated to a Facility or other enrollment type.
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Click the magnifying glass to search for a provider Group
Search for the provider Group to affiliate to by NPI, Provider ID, Name, or Organization.
Click on the Provider ID for the provider Group to affiliate to; make sure it’s the correct location.
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Choose the effective date for the affiliation, and then click Add
Continue to add additional Group affiliations as needed.
7. To remove an affiliation, simply fill in the end date of the affiliation and Save.
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8. Click the links on the left-hand side to edit other pieces of provider information, or click Go to Submit to submit all changes made
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9. Submit Changes
Attach any supporting documentation (if applicable), complete required fields, and click Submit.
10. Retain tracking number
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11. Check the status of an update request
Click the Provider Maintenance Status link.
Enter the Tracking Number for the update request, and click Search.
View Status details
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Group Provider Maintenance – Provider Web Portal Quick Guide
Provider Maintenance is where a provider updates information, including:
● Provider affiliations ● Provider Specialty and additional taxonomies ● Contact information (including who gets the emails for a provider) ● Opt-out of the Provider Directory ● License and board certification information and updates ● Insurance information ● Network Participation ● Disclosure information ● ACC opt-in changes
1. Login to Provider Web Portal
2. Click Provider Maintenance
PROVIDER MAINTENANCE PROVIDER WEB PORTAL QUICK GUIDE
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3. Click Provider Maintenance again
4. Click the links on the left-hand side of the screen to jump to that area, or just click Continue
Important To-Dos for a Group
Update the email address where we send provider related emails.
Update information for the Provider Look-up a. Opt-out of being listed in the directory
(Removal from directory listing) b. Indicate an open or closed panel
Ensure the correct Individuals within a Group are affiliated correctly:
a. A Group’s claims will deny if the Individual’s within a Group (rendering providers) on a claim are not affiliated to the Group (the billing provider).
b. If the Provider Affiliation Changes link does not show, updated affiliation information is not required.
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2
3
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5. To change address, opt-out of being listed in the Provider Directory, or to indicate an open/closed panel
Click Address Changes, then click on the + next to the address to change.
Opt-out of Provider Directory & changing the panel can only be done in the Service Location.
Edit address information, check or uncheck the applicable checkboxes, & click Save.
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6. To see all the providers affiliated to a Group
Click Provider Affiliation Changes
This Group only has one provider affiliated to it, Dr. Pepper Smith.
To add additional affiliations, click the + next to Click to add Provider Affiliation
Click the magnifying glass to search for a provider
Missing Affiliations? Individuals w/in a Group, are only allowed to affiliate to a Group. If
affiliations are missing, it’s because they were incorrectly affiliated to a Facility or other enrollment type.
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Search for the provider to affiliate by NPI, Provider ID, Name, or Organization
Click on the Provider ID for the provider to affiliate
Choose the effective date for the affiliation, and then click Add
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Continue to add additional affiliations as needed.
7. To remove an affiliation, simply enter the end date of the affiliation and Save.
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8. Click the links on the left-hand side to edit other pieces of provider information, or click Go to Submit to submit all changes made
9. Submit Changes
Attach any supporting documentation (if applicable), sign by entering the name and click Submit.
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10. Retain tracking number
11. Check the status of an update request
Click the Provider Maintenance Status link.
Enter the Tracking Number for the update request, and click Search.
View Status details
PROVIDER MAINTENANCE PROVIDER WEB PORTAL QUICK GUIDE
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Updating Malpractice or Liability Insurance
Providers must maintain an up-to-date record of their malpractice or liability insurance policy with Health First Colorado. Currently, there is no Provider Maintenance panel within the Provider Web Portal where providers can enter their insurance information.
In an upcoming Provider Web Portal update, a new Insurance panel will be added under Provider Maintenance which will allow providers to enter and submit their most recent insurance information. Until the change is implemented, whenever an insurance update is necessary, providers may submit their current insurance policy documentation and track the update by following the steps below.
1. Login to Provider Web Portal
2. Click Provider Maintenance
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3. Click Provider Maintenance again
Insurance documents are submitted through the Attachments and Submit panel. However, initially, the Attachments and Submit panel is grayed out and unavailable.
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4. Activate the Attachments and Submit panel one of two ways:
Click one of the links on the left-hand side of the screen to navigate to an area. The Attachments and Submit panel will now be active. Click Attachments and Submit.
OR
Click Continue until the Specialty and Contact Information Changes page is reached. Click the Go to Submit button. This will direct providers to an active Attachments and Submit panel.
Note: Users with the Fingerprinting panel will always be directed to the Fingerprint panel before being allowed to go to the Attachments and Submit panel.
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5. Submit changes.
Select Proof of Malpractice/Liability as the Attachment Type, attach the insurance document, sign by entering the name and then click the Submit button.
6. Retain tracking number
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7. Check the status of an update request
Click the Provider Maintenance Status link.
Enter the Tracking Number for the update request, and click Search.
View Status details
Need More Help?
Please visit the Quick Guides and Webinars web page to find all the Provider Web Portal Quick Guides.
