Due to implementation of the Illinois Medical Assistance Program Illinois Medicaid Program Advanced Cloud Technology (IMPACT), there is a period of time during which no applications that require HFS enrollment, will be processed. This period begins May 29, 2015.
Please visit the IMPACT webpage for more information.
The EI Central Billing Office (CBO) is the Illinois Department of Human Services (IDHS) designee for processing the state's payment of claims to Early Intervention (EI) providers, providing linkage with the Illinois Cornerstone System and maintaining provider data/interface with the Cornerstone system. Enrollment into the CBO is required for all EI providers with the exception of credentialed associates. EI providers become enrolled in the CBO by completing the CBO Enrollment Application CBO Enrollment Application. Provider Connections has developed a set of Supplemental Instructions Supplemental Instructions to assist in the completion of the CBO enrollment application for most types of enrollment and modifications to enrollment. Click here to view an instructional podcast explaining how to complete correctly.
The process of initial enrollment into the CBO requires the completion of a variety of documents compiled from several different state agencies. These include a contractual agreement with the Illinois Department of Human Services (IDHS), provider enrollment forms from the Illinois Department of Healthcare and Family Services (HFS), and a W-9 Taxpayer Identification Form for the Illinois Office of the Comptroller.
Providers and/or agencies in the EI system must enter into a Payee Provider Agreement to provide early intervention services in the state of Illinois. Once an agency has completed an agreement, subsequent enrollees for the agency are not required to complete the agency agreement. The purpose of the agreements is to establish the duties, expectations and relationship between DHS and the Provider who make service(s) available to eligible children and their families according to the Illinois Early Intervention Services System Act, Part C of the Individuals with Disabilities Act, the Health Insurance Portability and Accountability Act of 1996, and EI administrative rules. It is the responsibility of each provider to be familiar with the provisions of this agreement and to adhere to its requirements.
In most cases the HFS provider enrollment application must be completed. By doing so, providers will be enrolled in the HFSsystem as a provider of EI services only. By becoming HFS enrolled for EI services, providers are establishing a method by which IDHS may capture matching funds from HFS for services provided to EI eligible children. This is an interagency agreement between IDHS and HFS. On these application forms it is recommended that applicants use the address at which they may be contacted should their employment change. If this address changes, it is the providerÍs responsibility to notify HFS.
The Request for Taxpayer Identification form (W-9) is the document within the application that established the payee for EI services provided. With this document a provider/agency identifies to whom, how, and where payment is to be made for services provided by person(s) enrolled under that Federal Employment Identification Number (FEIN) or Social Security Number (SSN). Errors made on this document cannot be corrected by anyone but the person completing the application or agency representative.
ALL CBO enrollment application forms, whether initial or otherwise, must be sent to Provider Connections for processing. Do not send these documents directly to the CBO, IDHS, or HFS. Doing so will delay the processing of your enrollment. Technical support questions regarding the enrollment process should be directed to Provider Connections at (800) 701-0995.