EI Credentials Available in the Following Areas: Licensed Audiology Audiology Assistant

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EI Credentials Available in the Following Areas:
Mission Statement
Licensed Audiology (Credential/CBO enrollment required)
Audiology Assistant (Credential required; CBO enrollment not required)
Licensed Clinical Professional Counselor (Credential/CBO
The mission of Provider Connections is to ensure
that professionals working in the Illinois Early
Intervention System possess appropriate qualifications,
enhance their professional growth, and strengthen
their understanding of children ages birth to three
with developmental disabilities. As part of Western
Illinois University’s Center for Best Practices in Early
Childhood Education, Provider Connections assists the
Illinois Department of Human Services in providing
leadership in the Illinois EI System.
enrollment required)
Licensed Clinical Social Work (Credential/CBO enrollment required)
Licensed Dietician (Credential/CBO enrollment required)
Developmental Therapy (Credential/CBO enrollment required)
Developmental Therapy – Vision (Credential/CBO enrollment
required)
Developmental Therapy – Hearing (Credential/CBO enrollment
required)
Developmental Therapy – Orientation & Mobility (Credential/
What is Provider Connections – Early Intervention (EI)
Credentialing and Enrollment?
The mission of Provider Connections is to ensure that
professionals working in the Illinois Early Intervention System
possess appropriate qualifications, enhance their professional
growth, and strengthen their understanding of children ages birth
to three with developmental disabilities. Provider Connections
is contracted by the Illinois Department of Human Services
(IDHS), Bureau of Early Intervention, to credential and enroll EI
providers.
Provider Connections currently serves more than 5,000 providers
throughout Illinois and its adjoining states. The credentialing
and enrollment service links with several other state agencies,
including the EI Central Billing Office (CBO), the Illinois
Department of Public Aid, the Illinois Office of the Comptroller,
and the Illinois Medical Diagnostic Network.
CBO enrollment required)
Licensed Marriage & Family Therapy (Credential/CBO enrollment
required)
Registered Nutrition Counselor (Credential/CBO enrollment
required)
Registered Nurse (Credential/CBO enrollment required)
Licensed Occupational Therapy (Credential/CBO enrollment
required)
Certified Occupational Therapy Assistant (Credential required;
CBO enrollment not required)
Licensed Professional Counselor (Credential/CBO enrollment
required)
Counselor Assistant (Credential required/CBO enrollment not required)
Parent Liaison (Credential/CBO enrollment required)
Licensed Physical Therapy (Credential/CBO enrollment required)
Licensed Physical Therapy Assistant (Credential required; CBO
enrollment not required)
Licensed Clinical Psychology (Credential/CBO enrollment required)
Certified School Psychology (Credential/CBO enrollment required)
Service Coordinator (Credential/CBO enrollment required)
Certified School Speech Pathology (Credential/CBO enrollment
required)
Certified School Social Work (Credential/CBO enrollment required)
Licensed Speech Language Pathology (Credential/CBO enrollment
required)
Speech Language Pathology Assistant (Credential required; CBO
enrollment not required)
Provider Connections accomplishes its mission by . . .
• Issuing EI credentials to qualified professionals
• Enrolling service providers in the CBO
• Promoting public awareness and presenting at
statewide conferences
• Providing technical assistance regarding the Illinois EI
System
Linking the EI Credential Program with other State Agencies
Provider Connections Contact Information
Western Illinois University
27 Horrabin Hall
1 University Circle
Macomb, IL 61455
Phone: (800) 701-0995
Fax: (309) 298-3066
Website: www.wiu.edu/providerconnections
Office Hours:
Monday through Friday, 8 a.m. – 12 p.m. &
1 p.m. – 4:30 p.m. (excluding holidays and university closures)
Licensed Social Work (Credential/CBO enrollment required)
Social Work Assistant (Credential required; CBO enrollment not
required)
Early Intervention Non-Credentialed Services
Aural Rehabilitation (CBO enrollment required)
Assistive Technology (CBO enrollment required)
Deaf Mentor (CBO enrollment required)
Bilingual and Sign Language Interpreting (CBO enrollment/letters
of reference required)
Medical Diagnostic (CBO enrollment required)
Physician (CBO enrollment required)
Transportation (CBO enrollment required)
Ophthalmology (CBO enrollment required)
Optometry (CBO enrollment required)
The Provider Connections staff is available to assist EI service
providers with technical support related to the EI credentialing
process, the CBO enrollment process, and criteria for
maintaining/renewing the EI credential.
The Center for Best Practices
in Early Childhood
A Division of the
Center for Best Practices in Early
Childhood Education
Western Illinois University
IDHS Bureau of Early Intervention: Administers and
implements all policies/procedures for the Illinois Early
Intervention System.
Provider Connections: The IDHS Bureau of Early
Intervention’s designee for EI credentialing and enrollment
application processing and technical assistance.
Central Billing Office (CBO): The department’s designee
for processing the state’s payment of claims to EI providers,
and linkage with the Illinois Cornerstone System; maintains
provider data/interface with Cornerstone.
Cornerstone: Provides authorizations for services on IFSPs,
interfaces with the CBO provider system, and then CBO
calculates IFSP authorizations into dollar amounts.
Illinois Department of Public Aid (IDPA): CBO sends claim
to IDPA for Medicaid-eligible children for matching federal
dollars; links in provider databases.
Illinois Office of the Comptroller: Establishes payee from
CBO information. The CBO generates a list of services billed
to IDHS, IDHS reviews and forwards it to the Office of the
Comptroller, and the Office of the Comptroller issues a check
for payment.
United Cerebral Palsy of Greater Chicago (UCP): The
department’s designee for provision of EI training statewide.
(www.illinoiseitraining.org; Phone: [866] 509-3867).
Child and Family Connections (CFC): Umbrella organization
for the 25 regional intake entities within the Illinois EI
System. Responsible for implementation of the system within
a designated geographic area. These entities are the point of
intake for children and families into the Illinois EI System.
Early Intervention Credentialing Process
Early Intervention Credential FAQs
Early Intervention Central Billing Office Enrollment Process
Central Billing Office Enrollment FAQs
1. For initial credentialing, applicant completes an entire EI
credential application (including Ongoing Professional
Development Plan agreement) and a CBO enrollment
application (does not apply to assistants). All applications are
available at <www.wiu.edu/providerconnections>.
2. Applicants who have completed the required training(s) and
meet the educational, training, and experience requirements
are issued a “Full” credential that is active for three years.
3. Applicants who have not completed the required training
and/or experience requirements but do meet the educational
requirements are issued a “Temporary” credential that is active
for six months (except service coordinators/parent liaisons
whose credentials are active for 90 days).
• To fulfill the requirements of the “Temporary” credential
within the six-month credential period, all providers must
submit documentation of completion of the EI System’s
Overview Training (18 hours). Service coordinators/parent
liaisons must also complete their respective trainings and
submit documentation of such.
• 240 hours of supervised professional experience must be
documented and submitted at the time of initial application
or within the six-month “Temporary” period. (Does not have
to be face-to-face supervision meetings.)
4. Credentials must be renewed every three years
years.. Applicants
must complete an entire EI Credential Renewal application
(including Ongoing Professional Development Plan agreement
and monthly log of Ongoing Professional Development
activities for the previous three-year credentialing period).
Applicant must also submit documentation of completion of
30 hours of birth-to-three specific continuing professional
education, with a minimum of five hours per year and a
current copy of licensure (if applicable). Providers will
not receive notification of renewal. Expiration dates
can be verified on the lookup feature at <www.wiu.edu/
providerconnections>.
5. Evaluator/Assessment Credentialing
• In order to be eligible to provide initial evaluations to
determine eligibility for EI services, providers must hold
an EI credential and submit a separate portfolio to become
credentialed as an EI evaluator.
• Portfolios are reviewed quarterly.
• If it is determined that your application meets IDHS’s
minimum standards, you will be issued a six-month
evaluation/assessment credential. In the notification letter,
you will be instructed to complete and submit to Provider
Connections additional initial evaluations for review at
least eight weeks prior to the expiration date on the letter. If
you do not submit the required evaluations, your evaluator
credential will be inactivated on the expiration date. If you
do submit the required evaluations, it will be reviewed by
IDHS’s designee. If it is determined that the evaluations
meet the department’s minimum standards, your credential
will be “Full” and the expiration date will be made consistent
with other credentials you hold. If your evaluations are
determined not to meet the department’s minimum
standards, you will be notified in writing with both a letter
and a copy of the justification for denial.
Question: What is an EI credential?
Answer: The EI credential is directly linked to billing for
services. In order to provide services, either with an agency or
independently, the provider must first qualify and be issued
an EI credential for the profession for which they wish to be
credentialed. Unless a person intends to provide and bill for services
in the Illinois EI System, there is no need to have the EI credential.
Initial Enrollment
1. EI credentialing is contingent upon enrollment in the CBO
and the IDPA.
2. Applications are available at <www.wiu.edu/provider
connections> and must have original signatures.
3. Initial applicants complete all of the components of the CBO
enrollment application. All CBO enrollment applications
must be sent to Provider Connections. Complete applications
are processed at Provider Connections and forwarded to the
CBO within ten days of receipt.
4. CBO processes the application usually within five days of
receipt, uploads the data to the Cornerstone System, and
forwards the appropriate application materials to the IDPA for
enrollment and to the Illinois Office of the Comptroller.
Question: If I am currently enrolled through an agency and I
want to be a private provider, which forms do I need to complete?
Answer: Complete and return the forms on the Provider
Connections website labeled “Adding Individual Provider Status.”
These forms include the Individual Provider Agreement for
Authorization to Provide EI Services, the EI Service Matrix, and
the W-9 Request for Taxpayer Identification Number.
Question: Where do I get an EI Credential Application?
Answer: Applications are available on the Provider Connections
website: <www.wiu.edu/providerconnections>.
Question: Why/When do I need 240 hours of supervised
experience documented?
Answer: Either upon initial application or within the six-month
“Temporary” credential period, applicants must complete and
document 240 hours of supervised professional experience (30
hours for Audiologists) providing the EI services for which they
are being credentialed (use the Supervision Verification Form on
the Provider Connections website).
Question: What is the Ongoing Professional Development Plan?
Answer: All new/renewing credentialed providers in Illinois must
agree to participate in OPDP activities by using the Ongoing
Professional Development Plan Form. OPDP activities are a
face-to-face monthly meeting with an EI credentialed peer of
the same discipline/category. These meetings are intended to be
used for professional development through discussion of client/
family concerns, needs, strengths, resources, priorities, outcomes,
strategies, and service plans in order to support best practices.
Question: What do I need to complete to receive a “Full” credential?
Answer: To receive a “Full” three-year credential, you need to
meet the minimum education standards for the credential,
complete the 18-hour EI System’s Overview Training (service
coordinators/parent liaisons must also complete their respective
trainings), and document 240 hours of supervised professional
experience (30 hours for Audiologists) providing the EI services
for which you are being credentialed. These hours can be from
any EI experience that you have had throughout your career.
Question: When/What do I need to send with my renewal
application to Provider Connections?
Answer: Your credential expiration date is printed on your credential
certificate and in the cover letter attached to your credential.
Credentials are active for three years . For renewal, complete the entire
EI Credential Renewal application, the OPDP Form, the OPDP
documentation forms with the records of your activities, and 30 hours
of continuing professional education (minimum of five hours per
year) that are related to infants and toddlers with special needs during
the three-year credential period. Do not send the renewal application
in earlier than four weeks prior to your expiration date. Renewals
cannot be postdated; therefore, they are processed the week before
they expire. You can expect to receive your new credential within two
weeks after the expiration date. You will not receive notification that
it is time to renew your credential. You may look up your credential
information on the Provider Connections website.
Making Changes/Additions to CBO Enrollment(s)
1. To change your individual provider payment address in the
CBO, download, complete, and send to Provider Connections
the “Name/Address Changes” forms (EI Service Matrix and
W-9) on the Credential and Enrollment Applications page of
the Provider Connections’ website.
2. To change your Provider Agency/Company payment address
in the CBO, download, complete, and send to Provider
Connections the “Name/Address Changes” forms (EI Service
Matrix and W-9) for an individual already enrolled with
the agency, and attach a list of additional providers already
enrolled with the agency who are also effected by the payment
address change. These documents are found on the Credential
and Enrollment Applications page of our website.
3. To change your name in the CBO system, download,
complete, and send to Provider Connections the “Name/
Address Changes” forms (EI Service Matrix & W-9) on the
Credential and Enrollment Applications page of our website.
You must include with these documents a copy of the legal
document that changed your name (i.e., marriage certificate,
divorce decree). If you are enrolled as an independent provider,
the name change paperwork must reflect your independent
enrollment rather than enrollment with an agency.
4. To add yourself as an independent provider if you are already
enrolled with an agency provider, you must download,
complete, and send to Provider Connections the “Adding
Individual Provider Status” forms (Individual Provider
Agreement for Authorization to Provide EI Services, EI
Service Matrix, and W-9) on the Credential and Enrollment
Applications page of our website.
5. To add yourself as an agency provider if you are already
enrolled as a provider, download, complete, and send to
Provider Connections the “Adding Agency Provider Status”
forms (Provider Agency Agreement for Authorization to
Provide EI Services, EI Service Matrix, and W-9) on the
Credential and Enrollment Applications page of our website.
6. To add a new Provider Type if you are already enrolled as
another provider type (e.g., Physical Therapist enrolling as a
Developmental Therapist), you must first be credentialed for
that service and then complete and submit pages 5, 6, and 9 of
the CBO Enrollment Application to Provider Connections.
Question: If I am currently enrolled as an individual and I
want to enroll through/as an agency, which forms do I need to
complete?
Answer: Complete and return the forms on the Provider
Connections website labeled “Adding Agency Provider Status.”
These forms include the Provider Agency Agreement for
Authorization to Provide EI Services, the EI Service Matrix, and
the W-9 Request for Taxpayer Identification Number.
Question: What forms should I complete for a name change?
Answer: Complete and return the forms on the Provider
Connections website labeled “Name/Address Changes.” These
forms include the EI Service Matrix and the W-9 Request for
Taxpayer Identification Number.
Question: How do I enroll to provide Interpreting Services?
Answer: Although there is no credential for interpreters, you will
need to complete the CBO Enrollment Application (excluding
the Illinois Department of Public Aid Provider Enrollment
Application and the Agreement for Participation in the Illinois
Medical Assistance Program) on the Provider Connections
website. In addition, you must include two letters of reference
from nonfamily members.
Question: Since interpreters are not credentialed, are they
required to attend training to maintain enrollment in the CBO?
Answer: Yes, effective February 7, 2003, Rule 500 – EI states
that interpreters must attend the 18-hour EI System’s Overview
Training within six months of their CBO enrollment. Interpreters
will receive notification from Provider Connections upon the
processing of their enrollment indicating this requirement.
Question: How do I enroll to provide transportation services?
Answer: When either an individual or an agency enrolls to
provide transportation services, the entire CBO Enrollment
Application is required along with copies of all vehicle
registrations, driver’s licenses, and proof of insurance. If you are
enrolling as a parent transportation provider (only transporting
your child), the CBO Enrollment Application is required along
with a copy of your vehicle registration, driver’s license, and proof
of insurance.
.
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