Billing Documentation Requirements
You are required to maintain documentation to support each date of service and each procedure code that you bill to the EI-CBO for a period of at least six years from the child's completion of EI services, and permit access to these records by the
local CFC and DHS, or if they are Medicaid reimbursable services the Illinois Department of Public Aid and the Centers for Medicare/Medicaid Services (CMMS), and the United States Department of Education.
If there are outstanding audit exceptions, records shall be retained until such exceptions are closed out to the satisfaction of DHS. If there is active or pending legal action, records shall be retained until a final written resolution is achieved.
The Provider shall also make himself/herself available, as required, for mediation, impartial administrative proceedings or other legal proceedings.
Documentation is a chronological written account kept by you of all dates of services provided to, or on behalf of, a child and family. This includes IFSP development time and the results of all diagnostic tests and procedures administered to a child.
All documentation must be readable and understandable to families and to persons who will monitor or audit your billing to the EI-CBO. Documentation must include:
- Physician authorization/order
- Documentation of evaluation/assessment results (reports)
- Documentation of evaluation/assessment results (reports)Daily documentation of the services provided, including date and length of time of service billed, time in and time out for direct services, or time used in minutes for IFSP development. Daily
documentation is written and signed by the provider who actually provided the services and consists of a complete overview of the services provided for each procedure code and date of service billed.
- Progress documentation
- Documentation of continued physician authorization
- Documentation of discharge from treatment
- Supervision notes that document all contact between the supervisor who is responsible for a child's case and the associate level provider who is actually providing the direct service to the child.
Transportation providers' documentation should include:
- A travel log that documents all trips billed, including mileage, departure and destination information
Interpreter's documentation should include:
- Daily documentation of services provided, including date of service, discipline for which you have interpreted services and time in/out. Daily documentation should be signed by you as the provider who wrote the documentation
- Type of interpretation: verbal, sign, or written translation
- If written translation, type of document translated (ex: IFSP)
- Copy of the document to translate and copy of the final document after translation
In addition, providers should also keep the following:
- Copies of all authorizations under which you have billed for services
- A copy of the child's current IFSP
- Copies of all claims submitted to insurance and to the EI-CBO
- Copies of all Explanation's of Benefit received from insurance and the EI-CBO
- Any correspondence sent or received on behalf of the child
PLEASE NOTE: Providers who are not enrolled with the EI-CBO and associate level providers who are not Early Intervention credentialed, are NOT considered eligible Early Intervention providers and should NOT provide services to eligible Early
Intervention children unless approved through a provisional authorization.
In the absence of proper and complete documentation, no payments will be made and payments previously made will be recouped.