Providers

How do I refer to Early Intervention?

Use the Standardized Illinois Early Intervention Referral Form. Full completion of the form provides the EI team with information helpful to determine appropriate evaluations and services for the child. Send the form by fax to the appropriate Early Intervention Child and Family Connections office (CFC) based on the child’s zip code. If faxing is impossible, you or the parent may call the CFC directly. The local CFC can be located through the DHS Office Locator.

Illinois EI Program Referral Fax Back Form

Early Intervention Central Billing Office Billing Information for Providers

• Summary of Updates for Provider Handbook Revisions-R07-2022
• Final Draft Provider Handbook R07-2022
• EICBO Billing Information for Providers
• Billing Requirements for Paper Claim Submission
• List of Denial Codes
• How to Send Resubmitted or Corrected Claims to the Central Billing Office
• What Do I Do When My Claim is not Getting Paid
• IOC (Illinois Office of Comptroller) Website on Early Intervention Payments
• Illinois Office of Comptroller Website Link
• Early Intervention Central Billing 835 Files are Available through Availity 
• Billing Information Release Form (5/14) – CQuest is committed to protecting the privacy of 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. Please see the update regarding the Billing Information Release Form here: BIR Instructions.
• Transportation Billing Form (06/13) -This is the transportation services billing form for Early Intervention.
• 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.

Additional Provider Resources

• CFC Map Resource Live Link – A combination of the traditional CFC map with the list of counties and CFC contacts information into one digestible and easily navigable package.
• Early Intervention Training Program Resource Document: Working in Early Intervention as a Child Care Provider   English ¦ Spanish
• Early Intervention Documents, Forms, Reports and Worksheets
• CBO HIPAA Companion Guide
• Signing up for Electronic Provider Claim Summary (ePCS) Delivery- An ePCS is the electronic form of the paper Provider Claim Summary (PCS) that is printed and mailed by the Central Billing Office. The recipients of the ePCS receive the document via email. To learn more please read the Signing up for ePCS Delivery informational document. To get started,  contact the Early Intervention Help Desk at 1-800-634-8540.

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