Colorado Medicaid Change of Provider Form - Colorado

Colorado Medicaid Change of Provider Form - Colorado

Colorado Medicaid Change of Provider Form is a legal document that was released by the Colorado Department of Health Care Policy and Financing - a government authority operating within Colorado.

FAQ

Q: What is a Colorado Medicaid Change of Provider Form?
A: The Colorado Medicaid Change of Provider Form is a document that allows Medicaid recipients in Colorado to request a change in their healthcare provider.

Q: What information is required on the Colorado Medicaid Change of Provider Form?
A: The form typically requires your personal information, Medicaid identification number, current healthcare provider details, and the name of the new provider you wish to switch to.

Q: Can I use the Colorado Medicaid Change of Provider Form to switch to any provider?
A: No, you can only switch to providers who participate in the Colorado Medicaid program. It is recommended to verify the eligibility of your desired provider before submitting the form.

Q: How long does it take for a provider change to take effect after submitting the form?
A: The timeframe may vary, but typically it can take up to 30 days for your provider change to take effect.

Q: Do I need to notify my current provider about the change?
A: It is not mandatory to notify your current provider about the change, but it is generally recommended to inform them to avoid any disruption in your healthcare services.

Q: Is there a fee for submitting the Colorado Medicaid Change of Provider Form?
A: No, there is no fee associated with submitting the change of provider form for Colorado Medicaid recipients.

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Form Details:

  • Released on March 1, 2015;
  • The latest edition currently provided by the Colorado Department of Health Care Policy and Financing;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Colorado Department of Health Care Policy and Financing.

Download Colorado Medicaid Change of Provider Form - Colorado

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  • Colorado Medicaid Change of Provider Form - Colorado, Page 1
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