Explaining the Health Insurance Authorization (HIA) Form and Guardian Ad Litem (GAL) Guidance

The EI Colorado HIA Form is required for children who are enrolled in the Early Intervention Colorado Program. A form must be completed for each insurance plan that covers the child. Medicaid does not require consent for billing; Medicaid only requires consent to disclose personally identifiable information. The HIA Form gathers personally identifiable information about the child and family insurance coverage. Signing the form allows the Early Intervention program to bill the insurance for services listed on the Individualized Family Service Plan (IFSP) and for the insurance company to process claims. This form is not a consent for medical services and does not authorize any medical decisions. Whoever is the identified parent/guardian to make educational decisions should sign the HIA Form.

Consent can be authorized by:

• Parent of a child in Early Intervention

• Foster parent/guardian authorized to act as the child’s parent to make early intervention, educational, health, or developmental decisions

  • This includes GALs only in cases where they have been granted educational surrogacy

  • This does not include a child’s caseworker or other service providers

Early Intervention services will be provided without delay as listed on the IFSP and the funding hierarchy will be followed to identify the next funding source.

Early Intervention Colorado Resources:

• Health Insurance Authorization Form

• A Family Guide to the Coordinated System of Payments

• Notice of Child and Family Rights and Procedural Safeguards

• Part C of IDEA Definition of Parent