Important Notice

Notice Regarding Policy Change – January 4, 2006

In an effort to maximize resources, the Department implemented mandatory private insurance billing by DTs on July 1, 2005. At that time the Department indicated that the policy would be reviewed periodically to assess it’s cost-effectiveness. The Department has completed a review of the policy after six full months of implementation and has determined that it is not in the best interest of the program to continue this policy.

Therefore, effective immediately the policy mandating private insurance billing by Developmental Therapists (DTs) is rescinded. Any outstanding insurance claims submitted during July 1, 2005 through January 4, 2006, may be billed to the Central Billing Office. Authorizations for Developmental Therapy will continue to read BILL INSURANCE FIRST and DTs may continue to bill private insurance on a voluntary basis. However, mandatory private insurance billing by DTs, including DT-Hearing and DT-Vision providers, is no longer required.

Developmental Therapists who are waiting for claims that are being reviewed by private insurance companies may submit their claims without insurance Explanations of Benefits (EOBs) attached to the Central Billing Office (CBO) for prompt payment. If a duplicate payment is received from the private insurance company after payment has been made by the CBO and it meets or exceeds the CBO payment amount, the full CBO payment must be refunded. If a duplicate payment is received from the private insurance company after payment has been made by the CBO and it is less than the CBO payment amount, the portion of the CBO payment equal to the private insurance payment must be refunded.