(Autism) – Early Intensive Developmental and Behavioral Intervention (EIDBI) Provider Enrollment and Polices and Procedures

(Autism) – ​Early Intensive Developmental and Behavioral Intervention (EIDBI) Provider Enrollment and Polices and Procedures

(Autism) – ​Early Intensive Developmental and Behavioral Intervention (EIDBI) Provider Enrollment and Policies and Procedures

 

 

Who?

The Early Intensive Developmental and Behavioral Intervention (EIDBI) business package is for individuals looking to start an EIDBI company.

 

Why?

We have a workflow and system to get the EIDBI license. Our fee is refundable which means you either get the license or your money back. Since we have done over 20 EIDBI applications, we have experience with what will happen and how to navigate it quickly.

 

What is EIDBI?

​​Early Intensive Developmental and Behavioral Intervention (“EIDBI”) services offer medically necessary treatment to people under the age of 21 with autism spectrum disorder (“ASD”) or related conditions. The purpose of this service is to educate families of people with ASD, and improving the long-term quality of life of people with ASD by promoting independence and participation in their community and daily activities. 

Holt law provides complete provider enrollment with the Minnesota Department of Human Services for your EIDBI  / Early Intensive Developmental and Behavioral Intervention business including navigating all legal documents to run the business, internal business documents, training, insurance requirements, office requirements, background checks, and complete access to all required forms and compliance with DHS, Minnesota and Federal Law in a convenient electronic format for your use.

 

What do I need to start?

In order to enroll, every EIDBI agency must have an enrolled Qualified Supervising Professionals (QSP) OR Level I provider, employed by the agency, who has advanced certification in one of the approved DHS Treatment modalities. A Level 1 provider must be under supervision by a clinical supervisor, although technically the clinical supervisor would not need the advanced certification. Most commonly, EIDBI agencies enroll a QSP who has the advanced certification.

The Qualified Supervising Professionals (“QSP”) must meet the requirements listed in 7120C. This includes:

  1. at least 2,000 hours of supervised clinical experience or training in examining or treating people with ASD or a related condition or equivalent documented coursework at the graduate level by an accredited university in ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child development.
  2. a licensed mental health professional under Minnesota Statute 245.4871, subdivision 27, clauses (1) to
    (6) OR a developmental or behavioral pediatrician
  3. Certification in a DHS recognizes the following treatment modalities:
  4. Note: DHS may add other treatment modalities
  5. Proof showing you are qualified to provide EIDBI services, including but not limited to the following:
  • Licenses, Certifications, College Transcript(s) and Diplomas of practitioners to be listed

You could also enroll Level I, II or III providers using a combination of professionals. See here.

 

What is the process, and how long does it take?

The process generally takes 45 days from the date the Company has all of the required prerequisites. With information gathering and training in on legal forms the process usually takes 3 months from start to approval and starting to provide services.

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Onboarding (1-2 days)

We send onboarding documents to you 1-2 business days after your initial consultation. Onboarding documents include a Proposal, Rep Agreement, and Invoice.
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Questionnaire (1-2 days)

After the onboarding documents are received back, we will send you an EIDBI questionnaire. The questionnaire generally takes clients 1-2 days to complete. We're available for questions as you navigate through the questions.
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Prepare EIDBI Application (2-4 weeks)

After we receive your completed Questionnaire, we'll work on your application documents! This can take us between 2-4 weeks.
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Submit to Provider Enrollment (30 days)

After we complete your application documents and receive any necessary information/documents from you, we'll send you your completed application for review. The Provider Enrollment review process can take up to 30 days.
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Pending Onsite Visit (60 days)

Once the application has been submitted to Provider Enrollment, you will have a pending onsite visit that will occur within 60 days of the initial submission.
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Final Approval (2-4 weeks)

After your Onsite Visit has been approved, you will receive a final approval letter. The final approval letter is mailed 2-4 weeks after your onsite visit is approved.
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NetStudy 2.0 Request (2-3 weeks)

Finally, you'll receive a request to complete background studies in NetStudy 2.0. This request can take between 2-3 weeks.

How much does it cost?

  • EIDBI (Autism) – STANDARD package – $3950 Policies and Start to Approval Provider Enrollment
  • EIDBI PREMIUM Package – $11,950 Includes Standard package and all staffing until license approval (QSP and Level I EIDBI Provider)

Does NOT include the required $709 filing fee – 2024.  Does not include filing fees. Does not include staffing or locating qualified professionals (Premium package only). Does not include contracting and credentialing with insurance companies after approval (like Ucare, HealthPartners, etc). 

EIDBI Rates/Reimbursement for Services:

  • Comprehensive Multidisciplinary Evaluation (CMDE): Behavior identification assessment / 97151 / 15 min / $43.58
  • Individual Treatment Plan (ITP) Development and Monitoring / H0032 / per encounter / $82.44
  • Coordinated Care Conference: Medical Team Conference / T1024 / per encounter / $97.87
  • Intervention–Individual: Adaptive behavior treatment by protocol / 97153 / 15 min / $17.54
  • Intervention–Group: Group adaptive behavior treatment by protocol / 97154 / 15 min / $5.84
  • Intervention–Higher intensity: Adaptive behavior treatment with modifications in protocol administered by two or more providers / 0373T / 15 min / $21.04
  • Intervention–Individual: Observation and Direction: Adaptive behavior treatment with protocol modification / 97155 / 15 min / $17.54
  • Family or Caregiver Training and Counseling –Individual: Family adaptive behavior treatment guidance / 97156 / 15 min / $17.54
  • Family or Caregiver Training and Counseling –Group: Multiple family group adaptive behavior treatment guidance / 97157 / 15 min / $5.84
  • Travel Time / H0046 / 1 min / $0.45

 

FAQs

 

Can you help me find EIDBI qualified staff?Yes, depending on the package.
Please see our staffing options below:

  • EIDBI PREMIUM Package – $11,950 Includes Standard package and all staffing until license approval (QSP and Level I EIDBI Provider)
  • Full EIDBI Staffing ONLY – QSP and Level I EIDBI Provider – $8000
  • Staffing QSP ONLY (no Level 1 Provider) – $6000
  • Staffing – Level I EIDBI Provider ONLY (no QSP) – $6000
  • For Staffing – only staffed until approval – you can speak to provider about continued employment directly.

 

Do I need a center/clinic/facility?

No, a home office is acceptable. (Same requirements in regard to keeping client info secure) as long as there is no other medicaid-disclosing entities in the same location

 

What are the requirements for the center?

The lawyer would be able to advise you on this once you are onboarded as a client. 

 

What does the QSP need to be considered qualified?

They must be a licensed Mental Health Professional. The following individuals may provide services to a client as a mental health professional:

(1) a registered nurse who is licensed under sections 148.171 to 148.285 and is certified as a: (i) clinical nurse specialist in child or adolescent, family, or adult psychiatric and mental health nursing by a national certification organization; or (ii) nurse practitioner in adult or family psychiatric and mental health nursing by a national nurse certification organization;

(2) a licensed independent clinical social worker as defined in section 148E.050, subdivision 5;

(3) a psychologist licensed by the Board of Psychology under sections 148.88 to 148.98;

(4) a physician licensed under chapter 147 if the physician is: (i) certified by the American Board of Psychiatry and Neurology; (ii) certified by the American Osteopathic Board of Neurology and Psychiatry; or (iii) eligible for board certification in psychiatry;

(5) a marriage and family therapist licensed under sections 148B.29 to 148B.392; or

(6) a licensed professional clinical counselor licensed under section 148B.5301.

 

Do I need a BCBA?

If your QSP does not have advanced certification in the recognized treatment modalities, then you need an additional staff person. They must be a Level I EIDBI provider with advanced certification in one of the recognized treatment modalities. This is often a BCBA (Board Certified Behavior Analysis) but it can be other certified professionals.

 

For more information on the EIDBI program – see below:

1)               See Early Intensive Developmental and Behavioral Intervention (EIDBI) Benefit Policy Manual

2)               See EIDBI Benefit Page

3)               EIDBI – Background and Summary Overview of MN Autism Benefit Program

 

Read more about EIDBI on our blog

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