Verified October 10, 2026 against the statutes, regulations and sources cited below. General information, not legal advice. All states
What providers miss in Colorado
- The Division says it generally may not arbitrate, mediate or settle disputes over a provider's inclusion in or termination from a network (C.R.S. 10-16-121(4)), and asks providers not to use the consumer complaint portal.
- After a decision, carriers must give a physician applicant, on request, all non-proprietary information about the application and the final decision.
- The credentialing deadline covers physicians only; other clinicians have no statutory clock here.
Does Colorado have an any willing provider law?
No provider-wide any willing provider statute was confirmed for Colorado.
How long can a plan take to credential a provider in Colorado?
Carriers must finish credentialing a physician within 60 calendar days of a completed application and report the outcome within 10 days. They must send a receipt within seven days and flag an incomplete application within 10 days.
- Deadline: 60 days
- Applies to: Commercial carriers; physicians only
Citation: C.R.S. § 10-16-705.7
Can a provider practice in network while Colorado plans credential them?
If a carrier fails to send a receipt for a completed physician application within seven days, the physician becomes a participating physician no later than day 53 after the carrier received it.
- Provisional or interim credentialing
Citation: C.R.S. § 10-16-705.7(2)
What network adequacy rules apply in Colorado?
Managed care carriers must keep networks large enough that covered benefits are reachable without unreasonable delay, judged by provider ratios, geographic access, appointment wait times, hours and hospital access.
Citation: C.R.S. § 10-16-704(1)
Complaints trigger an investigation
The Insurance Commissioner enforces the credentialing law and must investigate once more than one applicant or participating physician complains that a carrier broke it.
Citation: C.R.S. § 10-16-705.7(10)
Will the Colorado insurance department take a provider complaint?
- Colorado Division of Insurance
- Does not decide provider contract disputes
Who oversees Medicaid managed care plans in Colorado?
- Colorado Department of Health Care Policy and Financing (Health First Colorado)
Turned down by a plan in Colorado?
We read the denial, check which of these rules reach that plan, and prepare the reconsideration request, the access-gap evidence and any regulator complaint the law supports; you sign and send them, and we track every deadline. Self-funded employer plans follow federal law, not Colorado's. A rejection review is $249, credited toward a dispute.