WebState of Illinois Department of Healthcare and Family Services Standardized Illinois Early Intervention Referral Form Please complete Sections 1 through 6 of this form to refer a child to Early Intervention (EI) for eligibility determination. Section 1. Child Contact Information Child Name: If the child is known by another name enter it here: WebIllinois Early Intervention Program (EICBO) Please follow the Enrollment Instructions below to become an electronic submitter to Illinios Early Intervention Program (EICBO) Special Enrollment Notes: Submitters must be the billing provider. Billing services may not enroll themselves as submitters. Solo providers = Billing providers

Getting Started in Early Intervention Illinois Early Intervention ...

WebAll providers entering the IL Early Intervention System are required to complete the Systems Overview Training. The Training Program works very hard to develop training curriculum that reflects Illinois policies and procedures as well as best practices in the field of early intervention. WebQclaims Features. Supports the CMS-1500 and UB-04 forms for import, direct data entry & print. Outbound transaction generation and automatic delivery of 837P and 837I files. … great clips martinsburg west virginia

Handbook for Providers of Therapy Services - hfs.illinois.gov

WebThe first step is to call your local Child and Family Connections (CFC) office to request a developmental evaluation. To find your local CFC office, call (800) 843-6154. A physician … WebEarly Intervention (EI): Illinois’ Early Intervention program’s mission is to assure that families who have infants and toddlers, birth to three years of age, with diagnosed ... (CBO) for payment. Contact Early Intervention at 1-800-634-8540 for service questions, and 217-782-1981 for billing questions. Fee-for-Service: http://illinoiseitraining.org/page.aspx?item=65 great clips menomonie wi