Rocky Mountain Health Plans - RAE

If you have questions about your health plan, please call us. Our toll-free Member Services number is 1-800-421-6204, TTY 711. We are open Monday through Friday, 8 am to 5 pm MST. 

Member Handbook - English
Member Handbook - Español

Already a member?

You have access to our member-only website. Print ID cards and more. View our Member Website 

It's important for us to ensure our Members, partners, and stakeholders have the information needed to learn about our Regional Accountable Entity initiative. Please, please find the relevant reports and resources.

• Governance Plan
• Annual Quality Report
• Annual Quality Improvement Plan
• Population Management Strategic Plan
• Annual Network Management Strategic Plan (Includes Practice Support Plan and Administrative Payment Report)
• Regional Program Improvement Advisory Council Materials/Minutes
• Member Advisory Council Materials/Minutes

CirrusMD provides the fastest connection to a board-certified doctor - answers to your healthcare questions are a text message away. Securely text, send photos, or video chat with a provider in the app right from your smartphone or computer. CirrusMD is available 24/7 for our Regional Organization (RAE), PRIME, CHP+ and DSNP Members at no cost.

Learn more about CirrusMD for RMHP

What Can CirrusMD Help With?

• General Health Questions: Do you have questions about medication side effects, lab orders/results, recommended health screens, or follow up questions after recent in-person care?
• Questions About Where to Receive Care: Before you schedule an in-person appointment or go to the ER, chat with a doctor instantly on CirrusMD.
• Urgent Care: coughs, fevers, sore throat, stomach pain, rashes, allergic reactions, animal/insect bites, and pediatric care such as common viral infections
• Mental Health: anxiety, depression, stress, insomnia
• Chronic Care and Prevention: Is your asthma under good control? Questions about weight loss, smoking cessation, managing diabetes, hypertension, or acne?
• Women’s Health: birth control, irregular bleeding, urinary tract infections, wellness

There are many ways to find a Primary Care Provider (PCP) or other providers, such as specialists. A specialist is a provider who works in one area of medicine, like a surgeon.

• Search for all types of providers in the Health First Colorado app or go to https://www.healthfirstcolorado.com/find-doctors/. Or contact your regional organization. The number is on your Health First Colorado card.
• To find a PCP, go to https://enroll.healthfirstcolorado.com/en or call 844-671-1266 or 833-962-2312 (State Relay 711).
• You can also download the RAE Provider Directory in English and Español. 
• To find dental providers, call DentaQuest’s Member Services at 855-995-1218 (State Relay 711).

These Clinical Practice Guidelines (“Guidelines”) are not meant to replace the clinical judgment of a Member’s physician or other professional health care provider (collectively, “Providers”). As such, these Guidelines do not establish a standard of care or practice or replace appropriate clinical decision-making. These Guidelines must always be used in the context of a health care Provider's clinical judgment in the care of a particular patient.

For that reason, Guidelines may be viewed as an educational tool to provide information and assist Members and Providers in choosing appropriate health care for specific clinical conditions and diagnoses. Deviations from the Guidelines may be necessary and appropriate in certain individual circumstances.

Publication of these guidelines is not a promise or guarantee of coverage. Individuals should review their coverage documents or contact RMHP Member Services at 800-421-6204 to determine what health care services are covered benefits and if other conditions or limits of coverage apply.

For more information around clinical guidelines, please visit: Clinical Practice Guidelines for RMHP

Colorado Statewide Standardized Utilization Management (SSUM) Guidelines - English

Colorado Statewide Standardized Utilization Management (SSUM) Guidelines - Español

RMHP is committed to protecting the confidentiality of your medical information to the fullest extent of the law. In addition to the laws that govern your privacy, RMHP has its own privacy policies and procedures to help protect your information. If you would like a copy of RMHP’s privacy policies and notices, visit https://www.uhccommunityplan.com/privacy-policy, refer to Notice of Privacy Practices in  the Member handbook, or call Member Services.

From the Health First Colorado Handbook:

Your rights
You have the right to:

1. Get the information in this handbook and about your coverage, plans, benefits and services
2. Be treated with respect and consideration for your privacy and dignity
3. Get information in a way you can easily understand
4. Get information from your provider about treatment choices for your health condition
5. Be involved in all decisions about your health care and say "no" to any treatment offered
6. Not be secluded or restrained as a punishment or to make things easier for your provider
7. Ask for and get a copy of your medical records and ask that they be changed or corrected
8. Get quality health care services in a timely and coordinated way
9. Use your rights without fear of being treated poorly
10. Any other rights guaranteed by law, for example HIPAA, ADA
11. Be free from discrimination based on race, color, ethnic or national origin, ancestry, age, sex, gender, sexual orientation, gender identity and expression, religion, creed, political beliefs, disability or health status
12. Ask your health plan for help if your provider does not offer a service you need because of moral or religious reasons

Your responsibilities
You have the responsibility to:

1. Understand your rights
2. Follow the Health First Colorado handbook
3. Treat other members, your providers and their staff with respect
4. Choose a primary care provider and go to Enroll. HealthFirstColorado.com. Or call 303-839-2120 or 888-367-6557 (State Relay 711) if you want to see a different provider.
5. Pay for services you get that are not covered by Health First Colorado
6. Tell your provider and Health First Colorado if you have any changes to your family, income, jobs, other insurance or address. Tell us within 10 days of the change.
7. Ask questions when you do not understand or want to learn more
8. Tell your provider information they need to care for you, such as your symptoms
9. Take medications as prescribed and tell your provider about side effects or if your medications are not helping
10. Invite people who will be helpful and supportive to you to be included in your treatment
11. Report suspected member or provider fraud or abuse to Member Fraud at 844-475-0444 or Provider Fraud at 855-375-2500. Or go to CO.gov/hcpf/how-reportsuspected-fraud.

You have many rights as an RMHP Colorado RAE member. You have the right to complain about RMHP. You have the right to complain about your care. You, your provider or a Designated Client Representative may complain about anything you are unhappy about or have a problem with. To get more information about appeals and grievances call Member Services.

If you need help with the information in this document, including written/ oral translation; or in a different format like large print or as an audio file, we can help you at no cost. You can get help by calling Rocky Mountain Health Plans (RMHP) at 800-421-6204 or State Relay 711 for callers with speech or hearing disabilities.

Quit Using Tobacco or Vaping Products

Quitting is hard, but we can help. Did you know that 20 minutes after you quit, your heart rate drops to a normal level? And within 24 hours after quitting the carbon monoxide level in your blood drops to normal.

Talk to your doctor about quitting. Or call 1-800-QUIT-NOW (1-800-784-8669) to get free coaching, counseling and supplies to help you quit.

Being healthy is not always about your urgent medical needs. Sometimes you may need help connecting to resources out in the community.

• These are things like housing, getting food every day or feeling safe. Visit findhelp.org for a list of community resources in your area. 
• Call 211 to get help for mental health, housing, food programs and more. 211 is a confidential and multilingual service connecting people to important resources. 

RMHP wants to help our Members get care from providers close to where you live.

For Medicaid we strive to make sure there are at least two behavioral health providers within your zip code or within these distances: 

• In urban areas, within a maximum time of 30 minutes or a maximum distance of 30 miles 
• In rural areas, within a maximum time of 60 minutes or a maximum distance of 60 miles 
• In frontier areas, within a maximum time of 90 minutes or a maximum distance of 90 miles

For Medicaid we strive to make sure there are at least two physical health providers within your zip code or within these distances: 

• In urban areas, within a maximum time of 30 minutes or a maximum distance of 30 miles 
• In rural areas, within a maximum time of 45 minutes or a maximum distance of 45 miles 
• In frontier areas, within a maximum time of 60 minutes or a maximum distance of 60 miles

For Medicaid we strive to make sure there are at least two specialty care providers within your zip code or within these distances:

• In urban areas, within a maximum time of 30 minutes or a maximum distance of 30 miles 
• In rural areas, within a maximum time of 45 minutes or a maximum distance of 45 miles 
• In frontier areas, within a maximum time of 100 minutes or a maximum distance of 100 miles

Medicaid providers should follow the following appointment timeliness standards:

• Behavioral Health
  • Urgent Care – within 24 hours of initial identification of need
  • Outpatient follow-up – within 7 days after discharge from a hospital
  • Non-urgent, symptomatic care visit – within 7 days after the request
  • Well Care Visit – within 1 month after the request, or in accordance with the Bright Futures Schedule. 
  • Emergency behavioral health care
    • By phone within 15 mins after initial contact,
    • In person within 1 hour of contact in urban and suburban areas
    • In person within 2 hours of contact in rural and frontier areas
  • Non-urgent, symptomatic behavioral health services – within 7 days after request
  • Member should not be place on a waiting list for any initial routine service requests
• Physical Health
  • Emergency – 24 hours a day, 7 days a week
  • Urgent Care – within 24 hours of initial identification of need
  • Outpatient follow-up – within 7 days after discharge from a hospital
  • Non-urgent, symptomatic care visit – within 7 days after the request
  • Well Care Visit – within 1 month after the request, or in accordance with the Bright Futures Schedule. 
  • Members should not be placed on a waiting list for any initial routine service requests