This page includes details and resources related to the Illinois Service Coordinator Community of Practice (IL SC CoP) Forum meetings on Navigating Financial & Insurance Conversations in EI. 

If you plan to participate in the forum, please follow our Community Guidelines (pdf) and register in advance. If needed, please download all slides (pdf). This forum's resource list (below) will be updated as the forum progresses.

Description

Service coordinators and other CFC personnel are invited to connect with EI billing and insurance experts at the Central BIlling Office (CBO).  This is an Q&A forum that addresses questions related to how EI is funded and the use of insurance for EI services. Topics may include (and are not limited to) insurance benefits verification, waivers, exemptions, authorizations, family participation fees, and health savings accounts. Participants can attend as they see fit based on their questions/needs. Prior to participating, we encourage you to complete a pre-survey to submit questions in advance.  See IL SC Forum schedule for times and date.

Objectives:

• Opportunity to gain answers to frequently asked questions from the EI billing and insurance experts at the CBO
• Gain confidence in explaining how EI is funded and insurance to families and caregivers so they can make informed decisions
• Gain a sense of community and learn new ways to navigate financial and insurance conversations from/with peers and EITP facilitators

Registration is required

Service coordinators with an active credential will be emailed a link to register about 2 weeks before this event.  If you do not receive the email, then you can register for the IL SC Forum meeting on "Navigating Financial & Insurance Conversations (w/ CBO)". Once registered, you will get a confirmation email that contains a pre-survey and Zoom information on how to join the meeting.  

EI Credit for Participation

1.25 hours in the EI Content Area of Working with Families will be awarded to participants.

Resources

Early Intervention Central Billing Office (EI-CBO)

EI-CBO is your best resource for all your billing and insurance concerns! The EI-CBO website facilitates information sharing with early intervention providers, early intervention program participants (parents or guardians), and Child and Family Connections agencies.

EI-CBO page for CFCs 

This page is specifically for Service Coordinators and other CFC staff and contains videos, job aids, forms, and instructions.

EI-CBO CFC Questions and Answers

This page of frequently asked questions (FAQs) from CFCs can help answer common questions.

EI-CBO Family Questions and Answers

This page of FAQs from Families can be a helpful resource when talking to families.  It includes common questions from families and answers from EICBO.

CFC Procedure Manual

Contains procedures, policies, and forms for Service Coordinators related to insurance and billing.

Modules on Illinois Systems of Payment in EI

These modules are part of the "Service Coordination Online"  training sponsored by the Early Intervention Training Program.  To view all resources for SC Online training, please visit https://go.illinois.edu/SCOnlineResources.  

Topics include:

• Notice of System of Payments and Fees
• Private Insurance
• Private Insurance Consents and Scenarios
• Public Insurance
• Family Fees

Resources by Topics of Interest

Paying for EI Services

• How EI Services are Funded (pdf) - provides a visual overview of the funding sources and the flow of funds for billing for EI services.  This handout also defines Payor of Last Resort and explains why we bill insurance first. 
• Billable and Non-Billable EI Services (pdf)

Using Insurance to Pay for EI Services

• Insurance Acronyms to Know (Word document) - includes a list of common acronyms and is editable so you can continue to add acronyms as you come across them.
• Private Insurance Process and Responsibilities (pdf) - illustrates who is involved in the private insurance process in EI and their respective responsibilities throughout the process.
• CFC Change of Insurance Notification form (pdf) from CFC Procedure Manual

Difference between self-funded and fully insured plans:

• Fully-insured plan—employer purchases insurance from an insurance company. The insurance company assumes the risk of providing health coverage for insured events.
• Self-funded plan—employer provides health benefits directly to employees and pays the claims as they occur.  The insurance company administers the plan and processes claims.  The employer assumes the risk of providing health coverage for insured events.

Non-employer self-funded and self-funded plans are covered in the following sections of Section 4 of SC Online training:

• Section 4 Module 1.2: Introduction to Private Insurance
• Section 4 Module 2.1: Utilizing Private Insurance
• Section 4 Module 3.1: Informed Consent for Insurance Use
• Section 4 Module 3.2: Private Insurance Consent Forms

Insurance Benefit Verification (BV)

• CFC Fax Coversheet for Insurance Benefit Verification Requests/Updates form - also called "Fax Coversheet" by EI-CBO- This form is available in the CFC Procedure Manual under Forms, and on the EI-CBO website.
  • Word document version (editable)
  • PDF version
  • Key to Central Billing Office Insurance Benefit Verification Form (pdf) - a guide from EI-CBO
  • Fax Coversheet Instructions from EI-CBO (Word doc)
  • It is submitted by Service Coordinators to EI-CBO via the following methods:
    • Via Fax as one submission (form and all required documents) to (217) 541-7475
    • Electronically through the secure CBO WebMail system (insurance@cquest.us) as one submission (form and all documents in one attachment like a PDF).
• Service Coordinator Process for Insurance Benefit Verification (pdf) - includes details on When to Complete the Fax Coversheet (BV form) and Gathering Data for Fax Coversheet (BV form) 
• Video on Benefit Verification Process for CFCs from EI-CBO 
  • Please note providers have a different process than CFCs
• Key to Central Billing Office Insurance Benefit Verification Form from EI-CBO (pdf)

Insurance Waivers

• CFC Pre-Billing Insurance Waiver Request (pdf) form from CFC Procedure Manual or fillable Word document version from EI-CBO
• Pre-Billing Waiver Requirements (pdf)
• There is no form for post-billing waiver requests. Providers are notified of any post-billing waivers on their Provider Claim Summary which they receive weekly from the CBO.
• Insurance Waiver slides (pdf)

Insurance Exemptions

• Insurance Exemptions Overview (pdf) - defines an exemption, lists reasons for exemptions, and outlines process, timelines, and impacts for exemptions.

Health Saving Accounts (HSA)

• CFC Tax Savings Account Information Sheet (pdf) from CFC Procedure Manual
• What’s the Difference Between an HSA, FSA, and HRA? by Mattie Quinn (for SELF.com, April 16, 2018)
• Infographic on Difference between FSAs vs. HSA by Napkin Finance

Family Fee

• Family Fee resources page - includes policies and procedures for family fees, questions and answers document, and a sample fee invoice.
• Paying for EI Services from EI Clearinghouse - also found in the Family Guide
• Please note the family fee is suspended temporarily during COVID-19 pandemic

Documentation

• Documentation: Rules, Tips, & Strategies (pdf)
• Example - Parent/Family Explanation of Benefits (EOB) from EICBO (pdf)