Quick Tips for Accessing Care

Now that I am a member of Denver Health Medicaid Choice (DHMC), where do I get health care for myself or my kids?

Denver Health Medicaid Choice is now your medical home. You can choose from one of the Denver Health community health centers or school-based health centers in to get your medical care.

  • Adult urgent care clinic open 8:30 am - 10 pm M-F and 10 am - 9 pm on weekends.
  • 24 hours a day/7 days a week:
    • Pediatric emergency room/pediatric urgent care
    • Adult emergency room

All Denver Health urgent and emergency care is located on the main Denver Health campus at 6th Ave. and Bannock St. If you have an emergency or urgent care need, you may go to any urgent care or emergency department, even if it is not a Denver Health facility.

Quick Tips for Accessing Care at Denver Health

  • If you have trouble finding a primary care provider (PCP) or you wish to change your PCP please call Member Services at 303-602-2116.
  • When making an appointment to see your PCP it is best to call after 9:00 a.m. If you have not been seen at a Denver Health clinic in the past 12 months or if you have never been seen at a Denver Health Clinic, call the Denver Health Appointment Center at (303) 436-4949 to make your first appointment. Once you have been seen at your Denver Health clinic, you can call your clinic directly to make all future appointments.
  • If you need to cancel your appointment, please be sure to call the Denver Health Appointment Center and let them know. Call at least one day before your appointment date, if possible.
  • Bring your Denver Health Medicaid Choice ID card, Fee-for-Service (regular) Medicaid ID card, and picture ID to all of your appointments.
  • The clinics and their phone numbers are included in the Denver Health Medicaid Choice Member handbook.
  • In most cases, you need a referral from your PCP to see a Specialist (a provider who is an expert in one or more areas of healthcare). You do not need a PCP referral to see a Specialist in optometry, dermatology or OB/GYN.
  • Be 15 minutes early for your appointment so you will have time for parking and checking in at the clinic.
  • All appointments can be made through the Denver Health Appointment Center line. This includes Women's Care, Primary Care, Specialty and Eye appointments. If you have problems getting your appointment, call Member Services at 303-602-2116, toll-free at 1-800-700-8140, or TTY/TDD 1-866-538-5288 (for the hearing impaired).

Accessing EPSDT Services

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is a Health First Colorado program (Colorado’s Medicaid Program) that covers prevention, diagnostic and treatment services for members age 20 and under. This program is set up to find health problems early. The program goal is for children to get the physical, mental, vision, hearing and dental care they need for their health. 

Your child can get these services at no cost to you.  Services include:

Members may self-refer for the following EPDST services:

  • Well Child Check-Ups
  • Immunizations
  • Vision Screening/Eyeglasses
  • Hearing Screening
EPSDT services that require a PCP referral and/or prior authorization (PAR):
  • Speech (PCP Referral)
  • Physical Therapy/Occupational Therapy (PCP Referral)
  • Home Health (PCP Referral and PAR)
  • Substance Use Disorders Treatment (PCP Referral and PAR)

The American Academy of Pediatrics Bright Future Schedule is a list of needed care and how often your child needs care.  For more information visit https://www.colorado.gov/hcpf/early-and-periodic-screening-diagnostic-and-treatment-epsdt

Age Check-up Frequency
0 to 15 months
  • Well child/physical - 8 visits
  • Dental - Every 6 months by age 1 or when first tooth breaks
  • Hearing - 1 check-up in hospital (at birth); 2 check-ups
  • Vision - 1 check-up

 

Age Check-up Frequency
18 months to 2 years
  • Well child/physical - 3 visits
  • Dental - Every 6 months
  • Hearing - 1 check-up after each middle ear effusion
  • Vision - 1 check-up at 2 years of age
3 to 20 years
  • Well child/physical - 1 visit per year
  • Dental - Every 6 months
  • Hearing - 1 check-up at ages 4-6, 8 and 10
  • Vision - 1 check-up per year from ages 3-8; 1 check-up every 2 years until age 20


In addition, children that have not had Lead Testing need to get one at 12 and 24 months or between the ages of 36 and 72 months.

You can get these services through your PCP within 30 days of calling for an appointment. Your PCP may refer you to other special services available at Denver Health.  EPSDT screening services do not need approval from Denver Health Medicaid Choice (DHMC). Diagnostic services as provided when screening suggests more evaluation or treatment is needed. Most medically necessary (least costly, effective, acceptable medical practice) services needed to treat, correct or prevent illness and condition found by screening or diagnostic tests are covered, and DHMC will not put limits (such as the number of visits allowed) on EPSDT services. Maintenance services may also be covered when needed.

Special Considerations or Limitations

There are some services not covered for EPSDT members. For a full listing please consult your DHMC Medicaid Choice handbook. 

Some EPSDT services are not covered by DHMC but are still a benefit to you through Health First Colorado. This kind of care is called a “wrap around” benefit. Please see the Wrap-Around Benefit section of the DHMC Medicaid Choice handbook for more information. 

Most EPSDT services will be available within Denver Health. Your doctor may also refer you to services outside Denver Health.  If you have questions about EPSDT services, you or your doctor may call DHMC Member Services (303)602-2116.  You can also call Healthy Communities. Healthy Communities is a free community resource to help you with finding EPSDT services outside of Denver Health. For more information please visit www.colorado.gov/pacific/hcpf/healthy-communities or call your coordinator. Tri-County (Adams, Arapahoe) 303-874-4404, Denver County 303-602-6770, Jefferson County 303-232-6301.