MedicaidAdministrativeMedium impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2000453 - 10/2020)
Colorado Medicaid·CO·Provider Bulletin
Effective date
Sep 26, 2020
We identified it
Jun 20, 2026
Summary
Colorado Medicaid (Health First Colorado) implemented a new ClaimsXten™ claims editing system effective September 26, 2020, that adds additional automated editing for professional and outpatient claims to identify inappropriate coding and reduce overpayments. The system excludes certain claim types like Medicare crossovers, dental, HCBS waiver, and inpatient hospital claims.
Action Required
Immediately: Billing team should review claim submission practices for Colorado Medicaid professional and outpatient claims as they now process through additional ClaimsXten™ editing. Monitor claim rejections more closely and ensure accurate coding. Attend available ClaimsXten™ training sessions on the Provider Training web page to understand new editing requirements.