Understanding Illinois' Systems of Payments

The purpose of this page is to provide a comprehensive list of all the forms and resources referenced in the Understanding Illinois' Systems of Payments training module.  Please remember that policies and procedures for how and when to use each of these forms can be found in the CFC Procedure Manual.

1. Forms
2. Resources
   1. Private Health Insurance Resources
   2. Public Health Insurance Resources
   3. Family Participation Fee Resources
   4. Insurance/Fee Resources
3. Resource Version: Understanding Illinois' Systems of Payments

Forms

The following forms are referenced in order of appearance in the training module.

• Notice of System of Payments and Fees (pdf)
• Family Participation Fees Program Fact Sheet (pdf)
• Acknolwedgment of Receipt of Notices (pdf)
• CFC Fax Cover Sheet for Insurance Benefit Verification (pdf)  & CFC Fax Cover Sheet for Insurance Benefits Verification Request Instructions (pdf)
• Tax Savings Account Information Sheet (pdf)
• Acknolwledgement to Decline Exemption for Tax Savings Account (pdf)
• Pre-Billing Insurance Waiver Request (pdf)
• Notice to Consent and Use Private Insurance (pdf)
• Notice To Consent To Use PrivateInsurance For Specific Service(s)(pdf)
• Screening Device for Determining Family Fees and Eligibility for AllKids and DSCC (pdf)
• Notice to Use Public Benefits - AllKids Enrolled or Potentially Eligible for AllKids (pdf)
• Consent to Collect, Store & Utilize Personally Identifyable Information (PII) (pdf)
• Family Participation Fees Agreement (pdf)
• Family Participation Fee Exemption Request (pdf)

Resources

Private Health Insurance Resources

• 10 Reasons to Use Private Insurance with Early Intervention (pdf): A guide for the discussions service coordinators have with families when they have private health insurance.
• Understanding Your Medical Insurance (pdf):  A handout service coordinators may want to share with families so they can better understand their medical benefits.

Public Health Insurance Resources

• 10 Reasons to Consider Applying for AllKids when Potentially Eligible (pdf): A guide for the discussions service coordinators have with families who are potentially eligible for AllKids.
• Five Reasons to Use Public Insurance for Early Intervention (pdf): A guide for the discussion service coordinators have with families who enter early intervention with public health insurance.
• AllKids Website (http://www.allkids.com/customers/): Where you will find more information on the All Kids program including the AllKids application.
• EI Training AllKids Resource Page: Where you will find resources as they relate to Healthcare for All Kids including a link to the All Kids website, an All Kids presentation, and All Kids training information.
• EI & the Medical Home Resource Page: Where you will find a variety of resources related to coordinating care between early intervention and the primary care medical home.  Care Coordination and analysis is one of the benefits of disclosing personally identifiable information between EI and the program that administers AllKids.

Family Participation Fee Resources

• Family Fees Resource Page:Where you will find a variety of resources related to family fees in the Illinois Early Intervention System. Resources include policies and procedures for family fees, a questions and answers document, and a sample fee invoice.
• Family Rights:Where you will find information as it relates to the family's role in early intervention and rights in both early intervention and special education. The Family Rights Handbook is also available for download on this resource page.

Insurance/Fee Resources

• Paying for EI Services Information Sheet (pdf): A resource developed by the Illinois Early Intervention Clearinghouse to assist families with some of their frequently asked questions around they payment for services.
• Insurance & Family Fee in Early Intervention (pdf): A resource developed by a service coordinator to help highlight the benefits of participating in early intervention even when private insurance is utilized and when there is a family participation fee.
• Family Fee and Use of Private Insurance (pdf):  A document that was developed by a service coordinator to help inform families of some key points about the family fee, use of insurance, exemptions, and benefits for use of insurance in early intervention.
• What to do when... (pdf): A guide to help service coordinators think about things to consider with a variety of scenarios they might encounter with families as they review the use of insurance and the family participation fee with them.

Resource Version: Understanding Illinois' Systems of Payments

A resource version of the online training Understanding Illinois' Systems of Payments has been developed for service coordinators, families and other early intervention stakeholders who have an interest in deepening their understanding of funding sources and the use of public and private insurance as well as family fees in lllinois' early intervention system.

If you have difficulty viewing a link, please email websupport@illinoiseitraining.org.