Rights & Responsibilities

As a Member of our regional organization, we want you to know your Rights and Responsibilities (tasks you need to do). When you know your rights and responsibilities, it gives you personal power to make good decisions about your health care. Please take time to click on the links below to learn more!

Access to Care – Our Commitment to You

Primary Care Medical Providers (“PCMP”) are required to serve Health First Colorado (Colorado’s Medicaid Program) Members as a Medical Home that is nearby, aiming to meet high access-to-care standards such as:

Provide reasonable hours of operation, including 24-hour availability of information, referral and treatment for emergency medical conditions.
24/7 phone coverage with access to a clinician that can triage Member’s health need;
Appointment availability on a weekend and extended weekday hours; and
Short waiting times in reception area.
- Urgent Care – within twenty-four (24) hours after the initial identification of need.
- Outpatient Follow-up Appointments – within seven (7) days after discharge from a hospitalization
- Non-urgent, Symptomatic Care Visit – within seven (7) days after the request
- Well Care Visit – within one (1) month after the request; unless an appointment is required sooner to ensure the provision of screenings in accordance with the Department’s accepted Bright Futures schedule

Behavioral Health Providers are required to render services to Members on a timely basis, as follows:

Urgent Care – within twenty-four (24) hours after the initial identification of need.
Outpatient follow-up appointments – within seven (7) days after discharge from a hospitalization.
Non-urgent Symptomatic Care Visit – within seven (7) days after the request.
Well Care Visit – within one (1) month after the request; unless an appointment is required sooner to ensure the provision of screenings in accordance with the Department’s accepted Early Periodic Screening, Diagnostic and Treatment (EPSDT) schedules.
Emergency Behavioral Health Care – by phone within fifteen (15) minutes after the initial contact, including TTY accessibility; in person within one (1) hour of contact in Urban and suburban areas, in person within two (2) hours after contact in Rural and Frontier areas.
Non-urgent, Symptomatic Behavioral Health Services – within seven (7) days after a Member’s request.
Administrative intake appointments or group intake processes will not be considered as a treatment appointment for non-urgent symptomatic care.
The RAE will not place Members on wait lists for initial routine service requests.