Overview of the EI-CBO Billing Process

Billing Rates

Providers are expected to bill the EI-CBO at their usual billing rates with the understanding that the EI-CBO will always reimburse up to the established Early Intervention rates. Providers should refer to the document entitled "Early Intervention Service Descriptions, Billing Codes and Rates" for detailed information on staff qualified to provide EI services, billable activities and rates of reimbursement. Providers who accept an Early Intervention authorization agree NOT to bill a child's family for payment above the Early Intervention rates.

Who can Bill?

Services are to be provided by a credentialed and enrolled provider. If services are provided by a credentialed associate level EI provider they must work under the supervision of a professional level EI credentialed provider who has a pre-approved authorization for the services to be provided.

The EI-CBO can reimburse an agency for Early Intervention services that are provided by an equally qualified provider who is Early Intervention credentialed/enrolled with the EI-CBO under the same discipline and is employed by the same agency the authorization was issued to. This policy ONLY permits substitution of those providers who are enrolled under the same agency's tax payer identification number.

Private Insurance Use

When a child enrolled in Early Intervention is covered by a private insurance plan, all credentialed providers must bill the insurance before submitting claims to the EI-CBO unless an exemption or waiver has been approved for the child.

Services Billable to Insurance

  • Assistive Technology (Durable Medical Equipment and Supplies)
  • Aural Rehabilitation Services
  • Developmental Therapy
    • DT/hearing
    • DT/vision
  • Health Services
  • Nursing Services
  • Nutrition Services
  • Occupational Therapy
  • Physical Therapy
  • Psychological and Other Counseling Services
  • Social Work and Other Counseling Services
  • Speech Therapy Services
  • Vision Services

Services Not Billable to Insurance

  • Audiological Exam
  • Medical Services (for diagnostic / evaluation)
  • Family Training and Support
  • Parent Liaison
  • Interpretation
  • Transportation Evaluation Services
  • Assessment Services
  • IFSP Development Services

Time to Bill

Claims for authorized services rendered on or after service dates of July 1, 2005 must be submitted to the EI-CBO no later than ninety (90) days following service delivery. In cases where third party payments exceed the Early Intervention rate, the provider's bill will be considered paid in full. The provider must submit the claim along with the insurance EOB showing the charges were paid in full. Charges that do not exceed third party recoveries should be submitted to the EI-CBO and will be paid up to the level of the Early Intervention rate. A copy of the insurance carrier's explanation of benefits must accompany the provider's billing to the EI-CBO.

Remittance from the EI-CBO

Attachment G: Sample Provider claim summary will explain the action taken on each claim and will be mailed from the EI-CBO. Claims approved for payment will be forwarded to the Illinois State Comptroller's Office for issuance of a check/warrant (Attachment H: Sample Comptroller Check). Providers can directly access payment information through the State Comptroller's web site. An online vendor's guide to accessing payment information is also available at the web site.

The Provider Claim Summary (PCS) and the check/warrant are sent under separate cover and can be matched according to the invoice number shown on the Provider Claim Summary and the invoice number on the state check/warrant. If you have questions regarding information contained within the Provider Claim Summary, contact the EI-CBO Call Center at (800) 634-8540. Please do not call the phone number listed on the State Comptroller's check/warrant.

The family will also receive an Explanation of Benefits. Families are requested to review their Explanation of Benefits (EOB) and report dates of service that were paid, but not received. Families who identify a discrepancy between services paid and services provided should contact the EI-CBO Call Center at (800) 634-8540 to report the discrepancy.