The Family Cost Share system is designed so families with the ability to pay will share in the cost of services.

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1 Paying fr Early Childhd Interventin Services What is ECI? Texas Early Childhd Interventin (ECI) prgrams serve families with children birth t 36 mnths with develpmental delays r disabilities. ECI prvides family supprt and specialized services t strengthen the family s ability t access resurces and imprve their child s develpment thrugh daily activities. ECI receives funding under Part C f the Individuals with Disabilities Educatin Act (IDEA), as well as frm the State f Texas. Additinal funding cmes frm the state s Family Cst Share (FCS) system. What is Family Cst Share? The Family Cst Share system is designed s families with the ability t pay will share in the cst f services. ECI staff will wrk with yur family t determine yur mnthly maximum charge. In ther wrds, the maximum amunt yu can be charged per mnth n matter hw many services yur family receives r hw many children yur family has enrlled in ECI. ECI prvides many services at n cst T help yu access initial ECI services, the fllwing services are prvided at n cst t yu: evaluatin and assessment, case management, develpment f an Individualized Family Service Plan (IFSP), and translatin and interpreter services, including sign language. These initial services help identify yur child s strengths and needs, as well as lcate resurces t meet thse needs. Yu will nt have t pay anything fr these services, hwever yu may be asked fr permissin t bill yur r yur child s insurance. Paying fr Early Childhd Interventin Services State regulatins require ECI t cllect payment frm yu t help pay fr yur child s services. Yu can pay fr yur child s services in tw ways: 1. use yur r yur child s private and/r public insurance (fr example Medicaid, CHIP, and TRICARE) and/r 2. make payments t ECI up t a mnthly maximum charge. 1

2 Yur payments t ECI cver the cst f services nt paid fr by insurance. This includes any c-pays, c-insurance, and deductibles required by yur insurance. Hw much will I pay t ECI each mnth? The amunt yu pay t ECI will depend upn: yur child s fster care status, yur child having Medicaid, the type and amunt f ECI services prvided in the calendar mnth, the amunt f mney ECI received frm yur r yur child s insurance, insurance c-pays, c-insurance, and deductibles, and family size and incme. Yur child s fster care status If the child yu are caring fr is in fster care r kinship care, yu will nt have t pay ECI anything. Because yu are nt financially respnsible fr the child, yu are nt required t prvide infrmatin abut yur family size r incme. Hwever, ECI will ask yu fr cnsent t cntact and bill Medicaid fr the services prvided t yur child. Yur child having Medicaid If yur child has Medicaid during the mnth, yu will nt have t pay ECI anything. Hwever, ECI will ask yu fr yur cnsent t cntact and bill Medicaid fr the services prvided t yur child. If yur child lses Medicaid fr any reasn, yu may have t pay ECI fr the services prvided t yur child. If yur child has Medicaid and private insurance, ECI must bill the private insurance befre ECI can bill Medicaid. ECI will ask yu fr cnsent t cntact and bill yur private insurance fr the services prvided t yur child. Type and amunt f ECI services ECI will nt charge yu fr services that are nt prvided. ECI will nt charge yu mre than what it csts t prvide the service. ECI will nt charge yu fr the fllwing n cst services: services funded by the schl district fr children with auditry r visual impairments, evaluatins and assessments, case management, develpment f yur child s Individualized Family Service Plan (IFSP), and translatin and interpreter services. ECI may charge yu fr the fllwing services: behavir interventin, ccupatinal therapy services, physical therapy services, speech-language pathlgy services, nutritin services, 2

3 cunseling services, nursing services, psychlgical services, health services, scial wrk services, transprtatin, specialized skills training, and assistive technlgy assciated with therapy services. The amunt f mney ECI received frm insurance The amunt f mney that ECI cllects frm yu and yur insurance cannt be mre than what it csts t prvide the service. Sme insurers d nt allw ECI t bill yu fr a service that an insurer is paying fr, even if the insurance payment des nt cver all f ECI s csts. Check with yur insurance t see what yur plicy allws. Insurance c-pays, c-insurance, and deductibles ECI cllects c-pays, c-insurance, and deductibles as set by yur insurance. Hwever, ECI will nt cllect mre than the maximum charge set fr yur family. Hw ECI calculates this maximum charge is described later in this bklet. The amunt yu pay ECI includes, and is nt in additin t, c-pays, c-insurance, and deductibles. Hw is my family s maximum charge calculated? Yur family s maximum charge will be calculated befre yur child receives the services identified n the IFSP, and at the annual IFSP meeting. Step 1 - State yur family s size. Yur family size includes yur child, the child s parents wh live in the hme, and yur ther dependents. These dependents d nt have t live in yur hme but they d have t be financially dependent upn yu. Step 2 - State yur family s annual incme. This infrmatin shuld be the same as the incme infrmatin used n yur federal incme tax return, befre allwed deductins. Yu can use the table belw t help identify the different types f incme yur family may have. Add all incme received, frm whatever surce, by all f the individuals that were included when calculating family size. 3

4 Incme Incme Type Parent 1 Parent 2 Child and Other Dependent(s) Wages, salaries, tips Self-emplyment incme Farm and fishing incme Unemplyment benefits Dividends and interest Other Grand Ttal Ttal If yu d nt prvide infrmatin abut yur incme, yur family will pay the full cst f services. Step 3 - Identify yur family s ECI deductins. Yu may subtract the fllwing frm yur incme if they are nt paid fr by anther surce: medical and dental insurance premiums, medical r dental expenses nt cvered by insurance, medical and dental c-pays, c-insurance, and deductibles, medicatin, medical supplies, and diagnstic devices, transprtatin t medical r dental care, debt payments fr medical r dental expenses, child care and respite expenses, adptin expenses, and child supprt payments fr children wh d nt live in yur hme. Yu can use the fllwing table t figure yur family s ECI deductins. 4

5 After reviewing yur expenses ver the last 12 mnths, list what yu expect t spend in the fllwing categries fr the IFSP perid. Yu may include any new expenses and unpaid balances frm the last 12 mnths. Include expenses fr all members f yur family. Allwable Deductin Type Parent 1 Parent 2 Child and Other Dependent(s) Ttal Medical and dental insurance premiums Medical r dental expenses nt cvered by insurance C-pays, c-insurance, deductibles Medicatin, medical supplies, diagnstic devices Transprtatin t medical r dental care Medical r dental debt that is being paid n an established payment plan Childcare and respite expenses Csts and fees assciated with the adptin f a child Curt-rdered child supprt payments fr children wh were nt cunted as family members r dependents in calculating the adjusted incme and family cst share amunt Grand Ttal Step 4 - T calculate yur ECI adjusted incme subtract yur ECI deductins frm yur incme grand ttal in Step 2. If yu d nt prvide infrmatin t ECI abut yur deductins, yu must use yur incme grand ttal frm Step 2 in Step 5. Step 5 - Lcate yur family size and ECI adjusted incme n the sliding scale. This scale is updated every year. The current scale is available frm ECI and at this link: Yur maximum charge is the dllar amunt listed under the clumn Mnthly Maximum Charge. If yu d nt prvide infrmatin t ECI abut yur incme r family size, yu will pay the full cst f services. Step 6 Cmplete and sign the Family Cst Share Agreement frm and the Cnsent t Bill and Release Infrmatin frm. ECI staff will help yu cmplete the frms. If yu chse t nt prvide infrmatin r give cnsent, yu still must check the apprpriate bxes and sign the frms. 5

6 If yu d nt cmplete and sign the Family Cst Share Agreement frm, ECI cannt deny r delay the prvisin f n cst services. Hwever, yur child cannt receive ther ECI services until yu cmplete and sign the Family Cst Share Agreement frm. Questins and Answers What if I dn t agree with the maximum charge fr my family? If yu disagree with yur maximum charge, yu have several ptins. Yu have the right t: request a review by an ECI manager r prgram directr, file an infrmal r frmal cmplaint with the lcal prgram r the Department f Assistive and Rehabilitative Services (DARS), request mediatin, and file fr a due prcess hearing. If yu wuld like mre infrmatin n hw t d any f these bulleted items, please see the Parent Handbk (http://www.dars.state.tx.us/ecis/publicatins/englishhandbk.pdf). Can my maximum charge be changed? Yu can ask ECI t review yur maximum charge if yur family size, incme, r deductins change during the year r due t financial hardship (fr example, yur hme is damaged by a trnad). While yur request is under review, yur last signed IFSP and Family Cst Share Agreement will remain in effect. Yur family size, incme, deductins, private and/r public insurance, and placement n the sliding scale will be reviewed and updated at least annually, at the annual IFSP meeting. What happens if I d nt pay my bill? ECI expects yu t pay yur bill in less than 30 days after yu receive the bill. Yur bill is past due if yu d nt pay yur bill in 30 days. Once yur bill is past due, yu have 90 days befre ECI must suspend the services fr which there is an ut-f-pcket charge. Befre suspending the services, ECI must remind yu that yu can ask fr a review f yur maximum charge and any past due amunt. When services are suspended due t nn-payment, services that are prvided at n cst, such as case management, will cntinue. When yur accunt is brught int gd standing after a suspensin, services will be restred. ECI cannt guarantee that services will be with the same individual prvider. What services are prvided at n cst t me? ECI prvides the fllwing services at n cst t yu: services funded by the schl district fr children with auditry r visual impairments, evaluatins and assessments, 6

7 case management, develpment f yur child s IFSP, and translatin and interpreter services. ECI will ask yu fr yur cnsent t bill yur child s private and/r public insurance fr evaluatins, assessments, and case management. ECI will nt cllect c-pays, c-insurance, r deductibles fr evaluatins, assessments, and case management. ECI must prvide the n-cst services listed abve withut delay, even if: yu d nt prvide incme, family size, r insurance infrmatin, yu d nt sign the Family Cst Share Agreement frm, yur maximum charge is being reviewed, r yu have nt paid yur bill and ther ECI services have been suspended. What services may be billed t my r my child s insurance? Sme f the services in yur child s IFSP may be cvered by yur insurance. With yur cnsent, ECI will submit claims n yur behalf t pay fr yur child s services. ECI will ask yu t sign a Cnsent t Bill and Release Infrmatin frm: befre cntacting yur r yur child s insurer (t verify cverage, c-pays, and c-insurance r t btain prir authrizatin), befre billing yur child s interventin services, each time a new service is added r there is an increase t an existing service (if yur child has private insurance), each time yu change insurance r managed care cmpanies, and annually (at the annual IFSP meeting). ECI will submit claims fr any f the fllwing services that are cvered by yur r yur child s insurance with yur cnsent: evaluatins and assessments, case management, behavir interventin, ccupatinal therapy services, physical therapy services, speech-language pathlgy services, nutritin services, cunseling services, nursing services, psychlgical services, health services, scial wrk services, transprtatin, specialized skills training, and assistive technlgy assciated with therapy services. What infrmatin will be shared with my r my child s insurance? ECI will share nly the infrmatin that is required t get apprval t prvide the service and submit claims fr payment. This usually includes the fllwing infrmatin: 7

8 Plicy hlder s name, address, telephne number, date f birth, gender, emplyer/schl name and plicy number(s); Child s name, address, telephne number, date f birth, gender, and relatinship t the plicy hlder; Other plicy infrmatin such as whether r nt the child s cnditin is due t an accident; Date, duratin, place, and type f service; and Diagnsis r reasn fr referral. If yur child has Medicaid r CHIP, the IFSP services page is the apprval fr services. If yur child has anther type f insurance, the insurer may request additinal infrmatin befre apprving services r paying. The insurer may request the fllwing types f infrmatin befre apprving services r paying: Physician s referral r prescriptin fr services; A statement f yur child s need fr services, including evaluatins and assessments; All pages f the IFSP; and A summary f yur child s prgress. Yu have the right t identify specific infrmatin that yu d nt want shared with yur insurance cmpany. This chice may affect the payment t ECI. If my child has insurance, will I still have t pay? Yu will have t pay fr services that are nt paid fr by yur r yur child s insurance. Sme insurers have c-pays, c-insurance, deductibles, and annual r lifetime benefit maximums. Yu will have t check with yur insurer r the member handbk t find ut: the services yur r yur child s insurance pays fr, the services that have a c-pay r c-insurance, the amunt f the c-pay r c-insurance, if yu have a deductible, the amunt f the deductible, and if there are any annual r lifetime caps. ECI can help yu cllect this infrmatin and explain hw yur insurance will help pay fr yur child s services. ECI cannt help yu select insurance r manage yur health care accunt. If insurance pays fr part f yur child s services, yu may be billed fr the unpaid part up t the cst f services r yur maximum charge, whichever is less. ECI will cllect c-pays, c-insurance, and deductibles. The amunt billed t yu fr services, c-pays, c-insurance, and deductibles added tgether cannt be mre than yur family s maximum charge. If insurance pays the ttal cst f all services, ECI will nt bill yu fr anything. Sme insurers require that ECI get permissin t prvide the service frm the insurer befre the service can be prvided t yur child (referred t as prir authrizatin). It is very imprtant that yu keep ECI up t date n yur r yur child s insurance. If ECI des nt get permissin befre prviding the service, the insurance may nt pay and yu may have t pay instead. 8

9 What are the advantages f using my insurance? The fllwing are pssible advantages t using yur insurance: Yur ECI bill may be less, Yur ECI services may cunt tward yur annual deductible, Yu will benefit frm the healthcare premiums yu have already paid, Help supprt the pssible need fr nging services after the age f three, and Help yu learn t wrk with yur insurance cmpany. What if my child has Medicaid r CHIP? ECI will ask yu t sign a cnsent frm and will submit claims n yur behalf, just like with ther types f insurance. It is imprtant that yu keep ECI up t date n yur child s managed care cmpany. Yu will need t sign a new cnsent frm each time yu change managed care cmpanies. If yur child has Medicaid during the mnth yu will nt have t pay ECI anything. If yur child lses Medicaid fr any reasn, yu will have t pay ECI fr the services prvided t yur child, up t yur family s maximum charge. If yur child has cverage frm the Children s Health Insurance Prgram (CHIP), ECI will bill yu fr any services that are nt paid fr by CHIP. CHIP des have c-pays fr sme services. The amunt billed t yu fr services nt paid by CHIP plus any CHIP c-pays cannt be mre than yur family s maximum charge. In the State f Texas, ECI services billed t either Medicaid r CHIP cannt result in: a decrease in yur child s lifetime Medicaid r CHIP cverage, yu paying fr services that wuld nrmally be paid by Medicaid r CHIP, increased premiums r discntinuatin f Medicaid r CHIP, r lss f eligibility fr any Medicaid hme and cmmunity-based waiver. What if my child has private and public insurance? If yur child gets Medicaid and als has ther insurance, yu were required t prvide this infrmatin n the applicatin yu cmpleted fr Medicaid. ECI will bill yur private insurance befre billing yur public insurance. If yur private insurance has a c-pay, c-insurance, r deductible and yur child has Medicaid during the mnth, ECI will nt bill yu fr the private insurance c-pay, c-insurance, r deductible. ECI will ask yu fr cnsent t cntact and t bill yur private and public insurance. If yu chse nt t cnsent t use yur public r private insurance, yu will pay up t yur maximum charge, based n yur placement n the sliding fee scale. What if my child des nt have insurance cverage? ECI cannt deny r delay yur child s services because yu d nt have private r public insurance. ECI cannt charge yur family mre fr services than it charges families with insurance. ECI cannt require that yu apply fr Medicaid r CHIP. Hwever, there are many benefits t having yur child enrlled in Medicaid r CHIP. Yur child will be eligible t receive dental and medical care frm ther Medicaid and CHIP prviders. Medicaid and CHIP eligibility is based n incme and family 9

10 size. ECI can help yu apply fr public insurance. Yu can g t the fllwing link t see if yur child may be able t get Medicaid r CHIP insurance: If yu decide t apply fr Medicaid r CHIP, ECI will give yu 90 days t apply and will nt bill yu fr any services during that time. After yur child is enrlled in Medicaid r CHIP, r after 90 days (whichever is less), ECI will review yur family s ability t pay and maximum charge. Yu will need t sign a new Family Cst Share Agreement frm at that time. What if I d nt have the ability t pay fr services? Yu d nt have t pay ECI fr services if yur family has an adjusted incme, after ECI deductins, f less than 100 percent f the federal pverty level. (See Step 3 f the Hw is my family s maximum charge calculated? sectin in this bklet.) ECI will use the infrmatin cllected in Steps 1 thrugh 5 t determine if yur family has the ability t pay. (See Hw is my family s maximum charge calculated? sectin in this bklet.) If yu disagree with ECI s determinatin f yur ability t pay yu have several ptins. Yu have the right t: request a review by an ECI manager r prgram directr, file an infrmal r frmal cmplaint with the lcal prgram r DARS, request mediatin, and file fr a due prcess hearing. Fr mre infrmatin n hw t d any f these bulleted items, please see the Parent Handbk (http://www.dars.state.tx.us/ecis/publicatins/englishhandbk.pdf). ECI must prvide the services n the IFSP even if yu d nt have the ability t pay fr services. ECI cannt deny r delay services because yu d nt have the ability t pay fr services. Rights What are my Family Cst Share rights? Yu have the right t: refuse any ECI service yu d nt want r d nt wish t pay fr; nt have yur persnal infrmatin released fr billing purpses withut yur written cnsent; stp yur cnsent t bill r release infrmatin at any time, and have yur ability t pay r maximum charge reviewed. Yu have a right t receive infrmatin abut hw ECI will: check yur family s reprted deductins, and calculate yur mnthly ECI bill. Yu have the right t receive services withut delay even if yu have been determined t have an inability t pay, chse t nt apply fr Medicaid r CHIP, and chse nt t cnsent t: release persnal infrmatin fr billing purpses, r 10

11 ECI billing yur r yur child s private r public insurance. Yu have the right t be infrmed f all f these rights and t have a cpy f this explanatin f the Family Cst Share plicy befre: giving ECI infrmatin abut yur family size, incme, ECI deductins, and insurance (private r public), and being charged fr services. Respnsibilities What are my Family Cst Share respnsibilities? Yu are respnsible fr: asking questins if yu d nt understand smething abut the Family Cst Share, making sure that the infrmatin n the Cnsent t Bill and Release Infrmatin frm is crrect and yu have signed it, making sure that the infrmatin f the Family Cst Share Agreement is crrect and yu have signed it, telling ECI when yur insurance r managed care cmpany changes, and paying yur ECI bill. What are ECI s respnsibilities? ECI will: 1. calculate yur adjusted incme, 2. determine yur ability t pay, 3. determine yur maximum charge, 4. calculate the cst f services, 5. keep track f the services delivered t yur child during the mnth, 6. identify the services yur r yur child s insurance pays fr, 7. submit insurance claims fr thse services n yur behalf, 8. determine which services, if any, have a c-pay, c-insurance, r deductible, 9. add up the c-pays, c-insurance, and deductibles fr services prvided, 10. add up the cst f services nt cvered by yur insurance, 11. add the amunt nt paid by insurance fr cvered services (if allwed by insurer), 12. cmpare this ttal (items 9 thrugh 11) t yur maximum charge, 13. bill yu fr the lesser f the tw the ttal f the items 9 thrugh 11 r yur maximum charge, and 14. use ECI federal, state, and lcal funds t pay fr yur child s services when insurance and yur payments d nt cver the cst f services. Additinal activities that ECI des at n cst t families: utreach activities t identify children wh may be eligible fr services, activities t make sure parents knw what their rights are regarding ECI services, and activities t prtect the parents and child s rights. 11

12 What If Chart If I chse t Nt prvide family size infrmatin Nt prvide family incme infrmatin Nt prvide ECI deductins infrmatin Nt sign the Family Cst Share Agreement frm Then I will pay the full cst f services I will pay the full cst f services My family s grss incme will be used t calculate the maximum charge My child will receive nly n cst services Insurance Resurces ECI has identified a number f internet resurces n the tpic f health insurance. These resurces prvide definitins f insurance terms and describe the different types f health insurance. The insurance resurces are at References Texas Administrative Cde, Title 40, Part 2, Chapter 108, Subchapter N Cde f Federal Regulatins, Title 34, Subtitle B, Chapter III, Part 303, Subpart F, ,

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