Families Questions & Answers

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Q: What is Family Fee?

A: A family participating in the Early Intervention (EI) program helps to pay for services they receive during their Family Fee effective period.

 

Q: How is my Family Fee assessed?

A: Family Participation Fees are assessed based on a family’s ability to pay. To determine ability to pay, EI compares household size and taxable reported income to the Federal Poverty Level on a sliding scale and considers out-of-pocket medical/disaster expenses. A family meets the definition of “able to pay” if the family falls within the scale and does not have proven out-of-pocket medical/disaster expenses in excess of 15% of the reported income.

 

Q: Insurance is paying for my services so why do I have to pay a Family Fee?

A: All families participating in the EI program that have an established fee, will receive a monthly invoice in order to make monthly budgeting payments. A Family Fee Invoice will be sent to each family monthly, regardless of insurance use. If the insurance company pays all of the EI providers’ claims at a rate higher than the EI rates, then each monthly Family Fee Invoice will display the EI amount paid to date as zero and the minimum due to date as zero. The Invoice data is updated monthly, so this information is current each month. However, if the insurance does not pay or only pays a portion of the claim compared to EI rates then there will be an amount due in fees. Please note that during deductible time frames insurance companies do not pay the claim therefore EI is the payer. Also, depending upon insurance plans, they may only cover a specific number of visits; therefore, after the max number of visits has been met, EI is the primary payer. In either case, due to EI payments, this will be reflected in Family Fees due. If you have further questions or dispute how the insurance processed the provider’s claim, you must contact your insurance company for further details.

 

Q: What is the policy for receiving a refund?

A: Refunds are given for Family Fee accounts when the family has paid more in fees than the EI program has paid in claims. Each Family Fee account will be reconciled 9 months after the end date of the IFSP listed on the Family Fee bill. After the reconciliation process any credit balances would be refunded to the family.

 

Note: A refund can be issued prior to the policy guideline of 9 months. The parent would request from each rendering provider a letter that clearly states they have completed all billing for the EI participant. Completed billing means they have received EOBs for all dates of service billed to EI and/ or insurance companies and there will be no further billing or corrections submitted.

 

If there is any chance that more claims need to be processed before the 9-month time frame has expired or if the letter from the provider is insufficient, the EI-CBO will not issue the refund. This is in effort to not issue a refund and then have to request some or all of the monies back due to additional processed claims.

 

Q: I am a parent of an EI participant. I have overpaid in Family Fees due and would like to receive my refund; however, I question why my Social Security Number is needed.

A: All refund checks are issued from the Illinois Comptroller’s Office for the EI program. The EI-CBO is responsible for requesting refund checks to be issued. In order to complete the request and in order for the Illinois Comptroller’s Office to issue the check, a current address and Social Security Number is required. Without appropriate address and Social Security Number information the EI-CBO cannot request a check and the Illinois Comptroller’s Office will not issue one.

 

Q: Why do I have Family Fee bills for each of my children?

A: If your family has more than one child in EI and is receiving more than one invoice, contact your Service Coordinator and notify them of the problem.

 

Q: What are my payment options?

A: You will be required to pay at least the Minimum Payment amount listed on your Family’s Fee invoice. Or, pay the Monthly Level Payment amount as indicated (this is the recommended payment option because it is the only way to make sure that your minimum due is never higher than the level payment amount).

 

Q: I can’t afford to pay Family Fee due to unemployment, medical or natural disaster, who do I notify?

A: Please contact your child’s Service Coordinator as soon as possible.

 

Q: Why do I have a Family Fee invoice and a Family Fee statement?

A:  The Family Fee invoice documents a current IFSP and the Family Fee statement documents the previous IFSP.  

 

Q: Why didn’t my child’s therapist bill DT to my insurance?

 A:  Under current EI guidelines, DT is not billable to insurance.

 

Q: Can I set up a payment plan with your office to pay my Family Fee?

A: No, family fee is already set up in level monthly payment installments.

 

Q:  Can I pay Family Fee with a credit card or over the phone?

A: No, currently payments can only be made by way of check or money order.

 

Q: To whom do I make the check payable? Where do I send my payments?

A: Make checks payable to Illinois Department of Human Services and send payments to Early Intervention, PO Box 3725; Springfield, IL 62708-3725. For your convenience, a return envelope can be found in your monthly statements.   

 

Q: What does the minimum due showing on my invoice or statement mean?

A: The Minimum Payment amount is based on how much the State has paid your EI service provider(s) for services subject to Family Fees. This amount may vary by month because providers have up to 90 days from the date of service or last written correspondence with the insurance company to bill for EI services. This means that the State may not pay anything for your family’s services subject to fees for several months.

 

Q:  Why is the Service Coordinator discontinuing my child’s services?

A: If a Minimum Payment amount becomes equal to three or more Monthly Level Payment amounts overdue, EI services subject to Family Fees, including Assistive Technology devices, will be discontinued with written prior notice to you. Services not subject to Family Fees may continue.

 

Q: Both EI and my insurance have paid for my child’s services, what do I do?

A: Contact the EI Help Desk at 800-634-8540 to inform them and you will be asked to provide proof of the insurance payment.

 

Q: How do I update my address with the EI-CBO?

A: Please contact your child’s Service Coordinator to give them this information.

 

Q:  I received a Parent Explanation of Benefit for services not provided to my child.

A:  Please contact the EI Help Desk to inform them of this issue.

 

Q: I’ve tried to reach my Service Coordinator several times, but no response.

A: Try contacting the Service Coordinator’s manager.

 

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