Signed Paperwork
What document gives the family permission to receive their child's records?
Bonus* (50 points): How can they receive their child's records?
Bonus* (50 points): If a child is in DCF custody, what page do you put DCF on and what page do you put the foster parents on?
The Request for Access Form
Bonus*: Email (secure or unsecure), Certified mail
Bonus*: You put DCF on the first and 3rd page. Foster parents go on the second page.
When is an annual review due?
Bonus* (50 points): Can it be completed late? Can this be completed early? If so, how early?
A year from the initial treatment plan or a year from the last annual.
Bonus: CANNOT be completed late (unless parents give permission for this). CAN be completed within 2 months before the due date.
What documents make up the Initial Treatment Plan?
Bonus* (50 points) Where can you find the referral date for the service grid?
EI Treatment Plan Signature Page, EI Eligibility Determination, Treatment Plan, Service Grid
Bonus: Preadmit note.
What documentation do you need on file if a child is medically eligible?
Documentation of their diagnosis!
Where can you find playgroup information in the folders?
Referral Forms & Partner Agencies.
What documents are signed by the Educational Surrogate during the initial evaluation?
EI Evaluation Consent, EI Treatment Plan, EI Eligibility Determination
When does billing need to be completed by?
Locked within 3 days.
Where can you find information about treatment plan/service grids (when to update, rules, & exceptions)?
Folders > Treatment Plan
If a child is born prematurely does that make them automatically eligible to receive EI services? If a child has Torticollis does that make them medically eligible? If a child has hearing loss, does that make them medically eligible?
No, yes, yes.
Where can you find visual supports in the folders and how can you create new visual supports (what is the program called)?
Resource folder > Lesson Pix
What forms should you bring to an Annual review that includes an assessment?
EI Evaluation Consent, CIS Authorization (updated annually or if permission to talk with/send info to new agencies has been given), CIS Permission to Bill (only needs to get signed if insurance has changed), EI Treatment Plan Signature Page
When does an IDA need to be locked by?
Within 10 days.
What is the difference between the planned start date and the actual start date?
Bonus* (50 points): When do you send a service grid in to be scanned into the client's chart?
Planned Start date: 30 days from the date of signed consent.
Actual Start date: Actual visit date that the provider went out to see the family for their first visit.
Bonus: When you've completed edits, have sent the plan for signatures, and when you have you confirmed the actual start date is accurate.
Where can you find information about who is medically eligible for EI?
Bonus* (50 points): What do we do if we don't know this information?
Folders: Medical Eligibility > Medically Eligible Information
Bonus: Email Leslie Davis to ask about whether or not the diagnosis makes the child medically eligible. Add info to the Medically Eligible Information sheet.
How do you bill for an initial evaluation and what episode do you bill in?
Bonus* (50 points): If a child is medically eligible, what do you bill for the initial visit if you do not complete an evaluation? If you complete an assessment later on, what do you bill this as?
Bill EI assess in the preadmit episode. Make sure client is admitted, then bill srvc plan and coordination in the admit episode.
Bonus: srvc plan and coordination, then srvc plan and coordination.
Please describe the CIS Permission to Bill form (including their options) as though you are talking to a family.
Bonus* (50 points): Please describe the CIS Financial Assistance Form.
Permission to Bill: This document gives the state permission to bill your insurance. You do have the right to choose to NOT bill your insurance. If you have multiple insurances, you can choose to have us bill through both of your insurances. We are a no cost to family’s service, so you shouldn’t ever receive a bill for services. If you give permission for us to bill your insurance, we bill insurance first, then everything else is covered through EI. If you ever receive a bill, don’t pay it, and let someone on your team know so we can get it covered.
CIS Financial Assistance Form: This form gives consent for EI to cover copays/deductibles so nothing comes out of your pocket. This form only needs to be filled out because you have private insurance.
In order to determine Potential Eligibility, how many months before a child's 3rd birthday does an assessment need to be completed by?
Within 9 months before their 3rd birthday.
When can you complete a service grid only update without needing to update the treatment plan?
You can do a service grid update without a tx plan for an increase or decrease in services. IF a service is discharged, you can wait to reflect this change on the next plan review, BUT make sure it’s documented in your notes. If goals change or a new service is added to the grid, a tx plan is needed.
What is the difference between the initial evaluation for a medically eligible child vs a child who is not medically eligible?
Bonus* (50 points): What do you bill the initial visit as if a child is medically eligible and what episode do you bill it in?
Medically Eligible: You do NOT need to complete an assessment if a child is medically eligible, especially if they are under 4-6 months old. You can immediately put the child on a plan by going out for the first visit with all the necessary paperwork (minus the ei consent to evaluation), stating parental rights, and going over tx plan questions/talking about services.
Bonus: Srvc plan and coordination in the admit episode for the initial visit. You will need to send an email to leadership to admit them BEFORE billing for this. Then, if you complete an assessment later on, the assessment will also be billed as srvc plan and coordination.
What is the percentage delay that a school district looks for on an evaluation for a child over 3 who is NOT transitioning from EI?
40% delay in one area or 25% delay in 2 areas.
Please describe the CIS Authorization form as though you are talking to a family, including why each partner is on the form. Partners include: PCP, childcare, UVMHH, SLPs, VT Dept of Health, Howard Center, UVM Medical Center, DCF Family Services, Head Start/Early Head Start, School District
Bonus* (50 points): When do we need to update the CIS Authorization form?
This form gives permission to talk with and release information to (when necessary) a variety of partner agencies, including your child’s pediatrician, the Howard Center (where we bill) and your child’s childcare (we sometimes do visits at childcare). Your school district is on there as well since our program ends when a child turns 3. Around 2 ½ years of age, we’ll start talking about the transition process to the school district if your child is potentially eligible to receive services through their school district after they turn 3. You’ll also see a variety of speech therapists on there as well and some other partner agencies. We’ve added these partners on here so families can get access to these services more quickly if they need them. You have the right to take any of the agencies/partners that aren’t necessary to your child’s service provision off of this form.
Bonus: Annually OR when the family gives permission for a new service to be in contact with/get documents from EI.
When does the PE letter need to be sent? When does the transition meeting need to be completed by? What is the exception to this?
Within 180-90 days before a child's 3rd birthday (transition window).
If a parent asks for a transition meeting to occur outside of the transition window (before or after), we can do this (make sure to note the parent's permission in EMR).
Please state parental rights (from memory) as though you are talking to a family.
Please explain the paperwork that needs to be completed after a child is determined eligible to receive Early Intervention services.
Bonus* (50 points): Note any differences that occur if the child is medically eligible instead of eligible.
1. Bill EI assess for the initial evaluation in the preadmit episode.
2. Send an email to leadership to admit them into the program.
3. Bill srvc plan and coordination in the admit episode.
4. Complete IDA, Tx plan, entry COSF, Preadmit Discharge, (Access to Care Timeline if not already completed).
Bonus: Make sure to get documentation of diagnosis on file. If assessment wasn't completed, bill srvc plan and coordination, do not need to complete IDA!
If your client is diagnosed with autism during their time in EI, what process should you follow and what documents need to be filled out?
1. Email Meghan to update the diagnosis code.
2. Get a copy of the diagnosis (send to avatarscanning).
3. Fill out the Autism Concerns or Diagnosis form (send to avatarscanning).
4. Update the tx plan.
5. Add Autism Concerns or Diagnosis form onto childcount.