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Behavioral Health

Rocky Mountain Health Plans is committed to expanding behavioral health access and choice in Colorado. We sincerely value behavioral health providers, community partners and other organizations who share our mission. Rocky Mountain Health Plans works with Optum Behavioral Health to manage the behavioral health network in Colorado.

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Credentialing submissions

You should submit all credentialing requests online to Optum Behavioral Health for all Rocky Mountain Health Plans behavioral health care professionals through Provider Express.

What you need to do:

  • Be responsive to any re-credentialing requests from Optum Behavioral Health on behalf of Rocky Mountain Health Plans
  • Initiate credentialing online with Optum Behavioral Health. You can find the credentialing process instructions at Provider Express

We require you to enroll in Health First Colorado, Medicaid to join Rocky Mountain Health Plans. If you have not completed this step please go to HCPF. Once you complete this step, you can submit a request to join Rocky Mountain Health Plans at providerexpress.com with your approved Colorado Medicaid ID.

Please Note: The Medicaid ID is required for Rocky Mountain Health Plans. You'll also need to include the Medicaid ID to add the Rocky Mountain Health Plans networks or this will delay enrollment.

Once you select the application type for your practice, follow the prompts for credentialing. If you don’t have one, you will need to create a One Healthcare ID in order to login to Provider Express.

  • Creating a new login begins the process for full credentialing. Once you submit the application, you will receive an email notifying you of where your submission is in the process.
  • Logging in as an existing user and are already credentialed, email Optum here and we can review and issue any needed requests on our end to add Rocky Mountain Health Plans network to your existing UnitedHealthcare contract

Please email rmhpRAE_BH_PR@uhc.com with any questions about the application process, or if you are needing any help with your Medicaid enrollment prior to submitting any applications.

Finally, please update your demographic information by logging into Provider Express and selecting My Practice Info.

  • Submit demographic requests online for all Rocky Mountain Health Plans behavioral health care professionals through the Provider Express portal. Select My Practice Info located on the right side of the page within Transactions. Allow up to 5 business days for your request to be completed.
  • Use the Add / Update / Inactivate Tax ID to change your tax identification information or add another practice location with a different tax ID number (TIN)
  • For more information or to get a User ID, visit the First-time User page

You must be revalidated and enroll with Health First Colorado to participate in the Rocky Mountain Health Plans Regional Accountable Entity (RAE) network.

RAE overview

Rocky Mountain Health Plans is the RAE for region 1 of the Health First Colorado Accountable Care Collaborative and is responsible for connecting Health First Colorado Members with primary care, behavioral health and community-based services throughout the region. Rocky Mountain Health Plans supports a comprehensive network of physical and behavioral health providers and ensures whole-person care is available to all members. Rocky Mountain Health Plans manages covered services under the Medicaid capitated behavioral health benefit and a payment reform initiative known as Rocky Mountain Health Plans PRIME.

The role of the RAE
  • Develop a cohesive health neighborhood where care is coordinated and integrated to meet the unique needs of each member
  • Enhance referral processes and access to specialty care
  • Develop a population health management plan to prevent the onset and negative impact of health conditions on member's lives
  • Promote collaboration and strategic programs with a wide range of community partners to address social determinants of health
  • Use evidence-based practices and promising local initiatives to impact overall health outcomes
Contract and engage with primary care medical providers
  • Develop and maintain a network of participating primary care medical providers (PCMPs)
  • Provide training and assistance to support primary care practice transformation
  • Offer targeted community funding and value-based payment models to enhance quality of care
Contract and engage with behavioral health care professionals
  • Develop and maintain a credentialed and contracted statewide network of behavioral health care professionals
  • Provide utilization management of covered behavioral health services
  • Reimburse behavioral health providers for services covered under the capitated behavioral health benefit
  • Provide training and support to behavioral health care professionals
Manage Early and Periodic, Screening, Diagnostic and Treatment (EPSDT) benefits

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is an important benefit for Health First Colorado Members and provides members with comprehensive and preventive health care services including preventive, dental, behavioral health, developmental and specialty services. EPSDT is available to children and youth ages 20 years and under, and members who are pregnant and enrolled in Health First Colorado.

To learn more about the RAE:
Submitting behavioral health prior authorizations

If you determine that a behavioral health prior authorization is required for your patient, you can submit a request in one of the following ways:

  • Email all clinical and request to rmhpbhvm@uhc.com
  • Fax all clinical and request to 970-257-3986
  • Call 888-478-4760 and ask to speak with the RMHP Behavioral Health Utilization Management Department
Learn more

Requirements of billing procedure codes for behavioral health services covered by Medicaid can be found using the State Behavioral Health Services Billing Manual.

 

Questions

If you have questions, contact the Provider Services department at 877-842-3210 or contact your UnitedHealthcare Provider Relations representative.

Rocky Mountain Health Plans is committed to building a more equitable health care system for underserved populations. Rocky Mountain Health Plans uses value-based payment (VBP) reimbursements to help sustain quality behavioral health services for Medicaid members, recognize outcomes over volume and distribute financial resources more equitably.  

Enhanced reimbursements are available to providers who are bi-lingual, safe-space providers (for members who identify as a part of the LGBTQIA+ community) and physically located in frontier counties among other qualifications.

The following documents provide details about the VBP program:

Claims processing

  • UnitedHealthcare processes all claims for Rocky Mountain Health Plans members.

Claims submissions

Use the electronic data interchange (EDI) payer ID 87726 for all plan types. Submit claims to the appropriate mailing address:

IFP
UnitedHealthcare Individual Exchange claim

PO Box 5290

Kingston, NY 12402-5290

Medicare
UnitedHealthcare Medicare Advantage claim

PO Box 31362
Salt Lake City, UT 84131-0362

Medicaid/DSNP/CHP+
UnitedHealthcare Community Plan

PO Box 5260

Kingston, NY 12402-5260

Claims payments
For claims with dates of service after Jan. 1, 2023, you’ll receive payments through Optum Pay.

Enroll in Optum Pay™ to get paid faster. Optum Pay is a free service that allows you to receive your claim payments and remittance advices electronically instead of through the mail. Your claim payments will be deposited directly into your designated bank account, and you can access all your payment and remittance advice information through Provider Express.

Learn more about Optum Pay

Suicide and crisis lifeline

Skilled, trained counselors are available to answer calls 24 hours a day, 7 days a week, at 988 (or 800-273-8255) or on the Lifeline Chat

Crisis help

Crisis help is available at no cost and is available 24 hours a day. Call 844-493-TALK (8255), or text “TALK” to 38255. 

We offer a wide variety of training and education materials to support your work the following courses may be of interest to you:

Visit the State-Specific Training page in health care professional education and training for all additional trainings.