CO · guidance
CO HCPF Home and Community Based Services (HCBS) Complementary and Integrative Health (CIH) Manual — Claim Submission
ClaimSubmission
Submissionofclaimsforservicesrenderedmustnotbeduplicative.Duplicateclaimsareanyclaimspaidacrossmorethanone(1)claimnumberforthesamebeneficiary,date,procedurecodeandservicestatebythesameProviderAgency.Duplicateclaimscanincludedifferentprocedurecodesbutwithoverlappingservicedefinitions.DuplicatesclaimsalsoincludeasingleProviderAgencyofferingmorethanone(1)servicesimultaneously.Alloverlappingservicesrenderedandsubsequentbillingclaimsmusthavesupportingdocumentationthatclearlyidentifiesthenecessityandnon-duplicationofoverlappingservicestoverifytheseserviceswereprovidedseparatelyandindependentlyofone(1)another.
RefertotheservicedefinitionsontheColoradoCodeofRegulationswebsitetoidentifyifclaimsareduplicative.RefertotheproviderspecialtycodeenrollmentrequirementsontheHCBSProviderSpecialtyCodeListwebpagetoidentifyservicesthatmustbeprovidedbyanindividualProviderAgency.
InanyinstanceinwhichduplicatebillingsresultinMedicaidreimbursement,arecoveryshallbemadebytheDepartmentagainsttheProviderAgency.
RefertotheGeneralProviderInformationManualforgeneralbillinginformationandclaimsubmissioninformation.
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TheHomeandCommunity-BasedServicesComplementaryandIntegrativeHealth(HCBS-CIH)waiverprogramprovidesavarietyofservicestoqualifiedMemberswithspinalcordinjury,braininjury,spinabifida,multiplesclerosis,musculardystrophy,andcerebralpalsywiththeinabilityforindependentambulationasanalternativetoaninpatienthospitalornursingfacilityplacement.MembersmeetingprogrameligibilityrequirementsaredeterminedfunctionallyeligiblefortheHCBS-CIHwaiverbytheCaseManager.
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Provenance
- Source
- hcpf.colorado.gov
- Retrieved
- 2026-07-26
- Edition
- 2026-07-26
- Content hash
34851cb874f8a5c17a44d2f2565b440828d6bca94ae5b13b5aca4e4ed560075c
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