Resource Library
This page contains frequently requested documents, links, and other resources. To find what you're looking for, click on the corresponding letter below or enter your term in the search field above. Can't find what you're looking for or have trouble accessing a document or link? Contact us.
A B C D E F G H I J K L M
N O P Q R S T U V W X Y Z
A
Advance Beneficiary Notification (ABN):
Advanced Beneficiary Notice of Noncoverage - Trailblazer Manual
ABN Form (revised 2011)
ABN Form Instructions
Advanced Directives
Information from Colorado Department of Regulatory Agencies
APN - Advanced Practice Nurses: See NP - Nurse Practioner
B
Bundling and edits: See CCI
C
Charging for Completion of Forms: See FMLA
Charging for Medical Records:
Physicians may charge a reasonable fee for the cost of copying the patient's medical record. See the CDPHE regulation for facilities for a guideline.
Closing a practice:
Medical Board guidelines for closing a practice
Collections:
Article 14: Colorado Fair Debt Collection Practices Act
Compliance plans:
OIG Compliance Program Guidance
Consumer complaint: See Division of Insurance
Consumer Protection Statute:
CRS 10-16-704 - Network Adequacy
CRS 10-16-705 - Requirements for carriers and participating providers
CRS 10-16-706 - Intermediaries
Contracting: See our Insurance page
Coordination of Benefits (COB):
COB: Tips for Reducing Payment Delays
DORA: Group Coordination of Benefits
Correct Coding Initiative (CCI):
Centers for Medicare and Medicaid Services CCI website
Credentialing:
Colorado Health Care Professional Credentials Application
Credit balances:
Colorado Unclaimed Property Act
American Bankers Association Article: "Uniform Disposition of Unclaimed Property Act"
D
Delegation and supervision:
Colorado Medical Board Rule 800
Discharging a patient:
Medical Board guidelines on discharging a patient
CMS policy and sample letter for discharging a patient
COPIC template letter to patients (COPIC insured login required)
Discount Health Card:
Consumer Alert
Discount Health Plans:
What Consumers Should Know
Division of Insurance:
Online complaint form
E
Electronic Communications:
AMA policy and guidelines
Electronic Health Records: See CMS/Component Societies' HIT page
Electronic Prescribing: See CMS/Component Societies' HIT page
Evaluation and Management (E&M) Services
Medicare Learning Network's E&M Services Guide
F
FMLA (Family Medical Leave Act)
US Department of Labor FMLA website
AAFP article on charging for completion of forms
G
H
HCFA 1500: See Health Insurance Claim Form
Health Facilities:
CDPHE - Health Facilities licensing website
Health Insurance Claim Form:
1500 Claim Form - National Uniform Claim Committee
HIPAA Privacy: See also: ICD-10 and Version 5010
HHS HIPAA Privacy webpage
AMA HIPAA webpage
'How to HIPAA' Top 10 Tips
AMA HIPAA Compliance Resources (includes sample Notice of Privacy Practices)
Hospice:
Hospice modifiers GV and GW - Trailblazer
I
ICD-10 code set:
Quick Reference Guide
Centers for Medicare and Medicaid Services ICD-10 webpage
AMA ICD-10 webpage
Incident to: See also Delegation and Supervision
Trailblazer "Incident to" Services Manual
J
K
L
Limited English Proficiency (LEP)
HHS Guidelines for LEP Patients
Locum Tenens/Reciprocal Billing:
Trailblazer Manual on Locum Tenens Billing Requirements
M
Medical records release/retention: See Records
Medicare Advantage
What You Need to Know (covers fee schedules, disputes and audits)
Medicare claim filing
Centers for Medicare and Medicaid Filing Instructions
Medicare enrollment/PECOS
PECOS FAQ
Centers for Medicare and Medicaid Enrollment webpage
PECOS login
TrailBlazer Tips
Medicare physician fee schedule:
Fee Schedule Search
Centers for Medicare and Medicaid Services Overview
Trailblazer - Medicare Fee Schedules
Medicare waiver: See Advanced Beneficiary Notification
Medicare wellness/preventive care: See Preventive services
Missed appointments
Medicare policy on charging for missed appointments
Modifiers
Trailblazer Modifier Manual
N
National Correct Coding Initiative (NCCI): See CCI
NP - Nurse Practitioner
Colorado Nurse Practice Act
Trailblazer Non-Physician Practitioner Manual
Non-par statute: See Out of Network
O
OIG Work Plan:
Office of the Inspector General work plan webpage
Out of Network:
Colorado statute that provides "full" payment for non-par services when insured is inpatient at a par hospital and was hospitalized by a par doctor. Intended to hold the insured harmless from out-of-network charges when hospitalized in a participating facility by a participating physician, and receives services from a non-participating physician that the insured did not choose, such as a pathologist, radiologist or anesthesiologist. See Consumer Protection Statute section 10-16-704
P
PECOS
Medicare Ordering/Referring Report
See also Medicare Enrollment
Physician Designation Programs/Profiling: See our Insurance page
Preventive Services
Overview of New Medicare Preventive Services
Prompt payment:
Fact Sheet - Colorado's Prompt Pay Statute
Physician Assistants:
Colorado Medical Board Rule 400
Trailblazer Manual on Non-Physician Practitioners
Q
R
Reciprocal billing: See Locum Tenens
Records:
Medical Board policy on medical records release and retention
Red Flags Rule:
AMA: What You Need to Know About the Red Flags Rule
AMA Sample Policy
Retroactive Adjustments: See Takebacks
S
Self-treatment:
Medical Board Policy 40-18
T
Takebacks:
See Section 4.5 of Consumer Protection Statute (CRS 10-16-704)
Terminating a patient: See Discharging a patient
Treating family members: See Self-treatment
U
V
Version 5010 Electronic Administrative Transactions:
AMA Version 5010 webpage
W
Waiver: See Advance Beneficiary Notice