Billing and Insurance
Monday - Friday | 8:00 AM - 4:30 PM
318 Broadway | P.O. Box 6347 (mailing address) | Eagle, CO 81631
We get asked this question a lot - if Colorado Mountain Medical and Vail Health are part of the same health system then why do they bill separately?
Colorado Mountain Medical and Vail Health joined forces in 2019 because we realized that, together, we can provide better care for our community than we can apart. Since the partnership is new, the billing systems are still separated as we have two different software solutions and practices in place. We understand that a better patient experience means that your patient statements all come from the same place, regardless of receiving your care from Colorado Mountain Medical or Vail Health. As opportunities to align systems become available, we are hopeful to work towards that goal.
Each insurance policy is different, depending upon:
- Your insurance company
- The amount of coverage that is part of your healthcare benefits package
- Your specific policy
Patients may be required to obtain authorization from their insurance company before they can receive treatment. It is a patient’s responsibility to obtain all necessary authorizations from their insurance company. To find out the details of your policy, contact the Customer Service or Member Services Department at your insurance company (the phone numbers are on your insurance card or in your benefits book).
Contracted Insurances Accepted by CMM as of January 2020-21
Because insurance plans are constantly changing, you are responsible for charges that may deny for out of network services.
- Aetna PPO: see list below for eligible plans
- Anthem BCBS PPO: see list below for eligible plans
- Cigna Healthcare PPO: see list below for eligible plans
- Cofinity: all PPO plans
- Humana: Choice Care PPO
- Rocky Mountain Health Plans PPO
- United Healthcare PPO
- Unicare (administered by BCBS)
- Anthem BCBS of Colorado HMO: see list below for eligible plans
- Colorado Access CHP Plus HMO
- Colorado Medicaid (State health plan) - up to age 18, limited >19
- Kaiser Permanente – MTNCo plan only
- Rocky Mountain Health Plans HMO
- Rocky Mountain CHP Plus HMO, Prime
- United Healthcare HMO Colorado
- United Healthcare Nexus ACO
- United Healthcare HMO- Out of state – (point of service plan only)
- United Healthcare Nexus ACO R (referral required)
- Multi Plan Private Health Care Systems (PHCS) eff 1.1.19
- Tricare- Prime (non-network participating provider) referral is required. Patient is responsible for obtaining referral.
- Tricare- Remote (non-network participating provider) referral is required. Patient is responsible for obtaining referral.
- Tricare- Tricare Standard/Reserve Select (non-network participating provider)
- TriWestVA – Patient responsibility to obtain an authorization.
Aetna: PPO Plans, Choice POSII, Elect Choice, Open Access Elect Choice, Aetna Select, Open Access Aetna Select, Open Choice, Managed Choice, Open Access Managed Choice, Traditional Choice (PPO), Dependent Out of Area Plan-TC, Dependent Out of Area Plan-PPO, HealthFund Managed Choice, HealthFund Choice POSII, HealthFund Open Access Elect Choice, HealthFund Open Choice, HealthFund Open Access Aetna Select, HealthFund PPO HSA, Health Fund MC HSA, Cofinity, Aetna Signature Plans.
BCBS PPO Plans: Anthem PPO, PAR, Blue Priority PPO Tier 2, FEP, WellChoice PPO Tier 1,
Colorado Anthem Medicare PPO, Blue Card World Wide PPO, Blue Card: must have a PPO in a suitcase logo on ID card; or can utilize the indemnity network of there is an empty suitcase logo. Out of network if PCP on card.
BCBS HMO Plans: Colorado HMO, (HMOC) Colorado Pathway HMO: Colorado Pathway X, Pathway, Pathway Network, and Mountain Enhanced HMO.
Cigna PPO: GWH-CIGNA, GWH-CIGNA Open Access Plus, SOS International, Choice Fund OA Plus, Open Access Plus, Local Plus, Local Plus IN Vantage, Local Plus Choice Fund, Local Plus IN Choice Fund, PPO.