Billing Information Release Form (5/14) – CQuest is commited to protecting the privacy of the Protected Health Information (PHI) and complying with HIPAA Privacy Rules and Regulations. In doing so the Billing Information Release Form must be completed by the provider prior to releasing or disclosing of any PHI BIR Instructions.
Transportation Billing Form (06/13) -This is the transportation services billing form for Early Intervention. Instructions
Electronic Billing– Qclaims is the Early Intervention Central Billing Office’s method of allowing EI providers to submit claims electronically to the Central Billing Office. This software is free, easy to use and completely HIPAA compliant. Additionally, it drastically cuts the time from claim submission to provider payment, creates a permanent record of your billing and submission dates, and reduces your cost of doing business in EI. To get started simply visit http://spiclaims01.eicbo.info/ and view the initial sign up documentation.