Welcome to the Early Intervention Provider Resource Center
EARLY INTERVENTION PROVIDER RESOURCE CENTER
Here you will find the essential resources, tools and information to effectively deliver Early Intervention services with New York Therapy. Whether you need guidance on procedures, access to important documents, or connections to key NYT contacts, everything is readily available to help you navigate your role with confidence and efficiency.
Meet the Support Team
Sonu Sanghoee, M.S., CCC-SLP, TSSLD
Early Intervention Director
Long Island & NYC
Long Island Team
Lauren Schnabel, MS, BCBA, LBA
EI ABA Manager
Long Island
Nancy Petrucelli, MA, Ed.
EI Manager
Long Island
Sandra Roditti, MAT
Ongoing Service
Coordinator Supervisor (OSC)
Long Island
Alyssa Santiago, MPPA
Ongoing Service Coordinator
Long Island
Jaime Dakers, LMSW
Evaluation Manager
Long Island
Ariana Cassiere, BS
Evaluation Coordinator
Long Island
Gina Dellapolla
EI Coordinator
Long Island Nassau
Rachel Gonzalez-Beach
Placement Coordinator
Long Island
Claudia Carbone
EI Billing Supervisor
Long Island & NYC
Lisa Holsborg
EI Billing Coordinator
Long Island
Hillary Teger
Senior Compliance Manager
Long Island & NYC
Jaclyn Dekhtyar
Compliance Coordinator
Long Island
New York City Team
Cynthia Alba, PTA
EI Service Coordinator Supervisor
NYC
Isabella Arboleda
EI Coordinator
NYC
Arturo Montero
Billing Coordinator
NYC
Hillary Teger
Senior Compliance Manager
Long Island & NYC
Val McIntyre
Compliance Coordinator
NYC
Key Resources
NYT Portal
Providers can view current caseload (treatment and evaluations) download pre-printed provider session notes, view prescriptions, view student records, and view compliance items.
NYT Portal
Compliance
All compliance, annual trainings, and requirements have been successfully completed as part of your onboarding packet. Please note that the following listed items are ongoing compliance requirements, mandated by New York State, the Department of Health (DOH), the Department of Education (DOE), and/or NYTPS, in accordance with district regulations and contracts with New York State. These requirements are due either annually, semi-annually, or every 2 to 3 years, as specified. Please note that you will receive regular email notifications regarding any upcoming or missing compliance requirements or documents. These “compliance issues” emails will provide ample notice prior to any items missing, coming due or expiring, helping you stay on track with all necessary documentation. Please contact the compliance department if you have any questions.
Annually Renewed Compliance Documents for All Providers
General compliance that NYTPS requires for all providers.
A6.0_EI Annual Health Assessment for Existing Providers
An annual physical health exam completed by a healthcare professional is required of all EI providers. Have your physician fill the NYTPS "Annual Health Assessment" form. This must include the annual TB screening Questionnaire attached (signed and dated by healthcare professional).
EI.1 TB Screening - Questionnaire
An annual physical health exam including an annual TB screening Questionnaire is required to be signed and dated by a healthcare professional. This form is also attached to the NYTPS annual physical form (to be signed and dated by healthcare professional).
T1.0 Annual TB Education Training and Acknowledgement
As per new NYS EI compliance requirements, this training needs to be completed annually. Please find the attached PDF including the instructions and links to the required NYS TB education sites. Once you have reviewed this information, please sign and date the acknowledgement and upload to the NYTPS compliance folder.
C1.0 Child Abuse - Mandated Reporter Training Info
All providers in NYS are required to have on file with NTYPS a completion certificate for; Child Abuse Recognition and Mandated Reporter training. All EI Providers are required to have on the most recent NYS updated training.
LI – Submit one time (most recent update 11/01/2022).
NYC – Required to complete and submit every two years.
C3.0 Corporate Compliance Plan Training Video
Annual training Video
C3.0 Corporate Compliance Training Acknowledgement
Annual Training, please watch the video, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
CSP1.0 Cyber Security Practices Training Video
Annual Training, please watch the video, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
CSP1.0 Cyber Security Practices Training Acknowledgement
Annual Training, please watch the video, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
D5.0-D5.1 Data Privacy & Security Training info & Acknowledgement
Annual Training, please watch the video, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
H13.0 Annual HIPPA Training Presentation
Annual Training, please read through presentation, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
H13.0 HIPAA Training Acknowledgement 2025
Annual Training, please watch the video, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
O1.0 OSHA Training Manual 2023
Annual Training, please read through presentation, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
O1.0 OSHA Training Acknowledgement
Annual Training, please read through presentation, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
S1.5 Sexual Harassment Training
All providers sign and submit annually.
S4.0 State Child Abuse Registry Database Check
All providers are required to be screened in the State Central Register Database of persons who are the subject of indicated child abuse or maltreatment report. Fill out an LDSS-3370 form and upload it to the NYTPS compliance folder.
Your completed application will be submitted to NYS for processing and clearance. Please be sure to include BOTH THE MONTH AND YEARS for all addresses listed. This must include ALL addresses for the past 28 years, or from birth if you are younger than 28. There can be NO gaps in dates.
NYC providers submit every 2 years.
Early Intervention Compliance - Additional Resources for EI
Additional compliance needed for EI Providers.
E6.0 EI DOH Provider Agreement
DOH agreement between provider and DOH to provide EI services. This agreement expires every 5 years.
E6.0 EI DOH Provider Agreement Instructions
DOH agreement between provider and DOH to provide EI services. This agreement expires every 5 years.
O3.0 OPRA Enrollment-Medicaid Number (OPRA - Ordering, Referring, Prescribing, Attending)
ALL SLP, Psychologists taking EI cases must obtain a Medicaid Number.
Submit every 5 years.
Early Intervention Billing
Here you will find information on how to bill for provided Early Intervention Services.
When submitting billing, please upload a single combined PDF file that includes your Invoice, EI Service Logs, and Session Notes. Files must be in PDF format only. Billing may be submitted on a weekly or bi-weekly basis.
Nassau County Billing Documents & Guidelines
The information in this section will guide you through the process. If you have any questions, please feel free to contact:
Claudine Carbone – Early Intervention Billing Supervisor – 631-388-7775 – [email protected]
Lisa Holsborg -Early Intervention Billing Coordinator – 631-469-3173 – [email protected]
Billing fax number: (631) 476-0967
Weekly Service Log
Have parent sign after each session and submit with your session notes
Confirmation of Late Start Date
To be completed by provider if services start 14 days after the IFSP start date should the case not start on time. Form is submitted online.
Request for Termination of Services
This form is submitted by the provider if services are being terminated. The form is to be submitted online.
Extended Non-Delivery of Services - LI
To be completed by the provider if the child has more than 3 or more consecutive absences. This form is submited online.
Consent for Telehealth - English
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTPS.
Consent For Telehealth - Spanish
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTPS.
Suffolk County Billing Documents & Guidelines
The information in this section will guide you through the process. If you have any questions, please feel free to contact:
Claudine Carbone – Early Intervention Billing Supervisor – 631-388-7775 – [email protected]
Lisa Holsborg -Early Intervention Billing Coordinator – 631-469-3173 – [email protected]
Billing fax number: (631) 476-0967
Weekly Service Log
Have parent sign after each session and submit with your session notes
Confirmation of Late Start Date
To be completed by provider if services start 14 days after the IFSP start date should the case not start on time. Form is submitted online.
Request for Termination of Services
This form is submitted by the provider if services are being terminated. The form is to be submitted online.
Extended Non-Delivery of Services - LI
To be completed by the provider if the child has more than 3 or more consecutive absences. This form is submited online.
Consent for Telehealth - English
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTPS.
Consent For Telehealth - Spanish
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTPS.
NYC/5 Boroughs Billing Documents & Guidelines
The information in this section will guide you through the process. If you have any questions, please feel free to contact:
Arturo Montero – Billing Coordinator – 516-454-1509 – [email protected]
Billing fax number: (631) 476-0967
Weekly Service Log
Have parent sign after each session and submit with your session notes
Request for Termination of Services
This form is submitted by the provider if services are being terminated. The form is to be submitted online.
NYC Extended Non-Delivery of Services
To be completed by the provider if the child has more than 3 or more consecutive absences. This form is submited online.
NYC Gap in Services
To be completed by the provider if the child has more than 3 or more consecutive absences. This form is submited online.
Confirmation of Late Start Date
To be completed by provider if services start 14 days after the IFSP start date should the case not start on time. Form is submitted online.
Consent for Telehealth - English
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTPS.
Consent For Telehealth - Spanish
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTPS.
Tips and Resources
Here are helpful resources for EI providers.
General Resources
Useful Websites
Helpful Websites
Nassau County DOH EI website
Nassau County Department of Health - Early Intervention Website
New York State Department of Health Bureau of Early Intervention – BEI
NY State EI Website
NYC EI List of Resources to support Quality and EI Best Practices
NY State EI Website
OCFS - Office of Child and Family Services Website
NYS website regarding child abuse. How to report, who is mandated reporter.
Tech Support and How-To’s
Instructional Video’s and How to’s
How to sign a PDF on your Android Device
How parents can sign log notes or forms using their Android device.
How to sign a PDF on your iPhone and iPad
How parents can sign log notes or forms using their iPhone or iPad.
How to View Secure Emails from NYTPS
Directions on how to view secure emails from NYTPS.
EnterCLAIMS (for NYT Kids Pediatric Therapy Center Providers only)
Instructions
Step by step instructions for EnterCLAIMS, from how to create an account to how to sign your billing, send to NYTPS, and everything in between!
Videos
EnterCLAIMS FULL Training Video
EnterCLAIMS Training Video
XII. How to Create a Digital Order
Please click the link and register ( just for tracking purposes) then the recording will start.
Resources
Find a Form
Find Start up forms (forms needed when starting a new case), Service forms and Progress Reports.
Nassau County
1. Evaluation Forms
Nassau County EI Bilingual Consent (Bilingual Evaluation Justification)
Prior to conducting a BILINGUAL evaluation, must be completed and signed by parent and evaluator. Fax or upload in the Document Submission section at the bottom of this page.
EI Family Assessment Spanish
Prior to conducting an evaluation, must be completed and signed by parent and evaluator. Fax or upload in the Document Submission section at the bottom of this page.
NYTPS EI Supplemental Consent Packet
Prior to conducting a supplemental evaluation, must be completed and signed by parent and evaluator. Fax or upload in the Document Submission section at the bottom of this page.
EI Home Language Survey
Conducted to establish the percentage of bilingualism in the home. Fax or upload in the Document Submission section at the bottom of this page.
NYTPS EI Consent Packet - 2023
Prior to conducting an evaluation, must be completed and signed by parent and evaluator. Fax or upload in the Document Submission section at the bottom of this page.
2. Start Up Forms
All forms needed when starting a new case through NYTPS.
Consent for Alternate Signature
Parent authorizes someone else to sign session note and/or service log. Provider to send back to NYTPS with billing.
Consent for the Use of Telehealth - English
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTPS.
Consent for the Use of Telehealth - Spanish
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTPS.
Consent to Email and Text - English
Consent from parent/gurardian to exhange information regarding the child via email or text. Complete and fax or upload to NYTPS.
Consent to Email and Text - Spanish
Consent from parent/guardian to exchange information regarding the child via email or text. Complete and fax or upload to NYTPS
PINS - Personnel In Need Of Supervision Form
This form needs to be completed by CFYs, COTAs, and PTAs, for supervision purposes.
Speech Referral
To be completed for each child on your caseload for each IFSP period.
3. Service Forms
Forms that may need to be completed during the authorization period.
Confirmation of Late Start
To be completed by provider if services start 14 days after the IFSP start date should the case not start on time. Form is submitted online.
Consent to Email and Text
Consent from parent/gurardian to exhange information regarding the child via email or text. Complete and fax or upload to NYTPS.
Consent for Alternate Verification Signature
Parent/guardian authorizes someone else to sign session note and/or service log. Provider to send back to NYTPS with billing.
Extended Non-Delivery of Services - LI
To be completed by the provider if the child has more than 3 or more consecutive absences. This form is submited online.
IFSP Amendment Request
Provider to complete if a change or amendment is being requested prior to to the end of the authorization period. Complete and fax or upload to NYTPS.
Request for Termination of Services
This form is submitted by the provider if services are being terminated. The form is to be submitted online.
Speech Referral
To be completed for each child on your caseload for each IFSP period.
4. Progress Report Template
Complete and either fax or upload through the site. Reports sent via email will not be accepted.
6 Month Progress Report Template
Template can be used for 6 month or discharge reports. Complete and fax to the Early Intervention Department or upload through the site. Emailed Progress will not be accepted.
ABA Team Leader 6 Month Progress Report
Template can be used for 6 month or discharge reports. Complete and fax to the Early Intervention Department or upload through the site. Emailed Progress will not be accepted.
ABA Team Leader Family Training Progress Report
Template can be used for 6 month or discharge reports. Complete and fax to the Early Intervention Department or upload through the site. Emailed Progress will not be accepted.
ABA Team Member Progress Report
Template can be used for 6 month or discharge reports. Complete and fax to the Early Intervention Department or upload through the site. Emailed Progress will not be accepted.
Suffolk County
1. Evaluation Forms
Suffolk County EI Bilingual Consent (Bilingual Evaluation Justification)
Prior to conducting a BILINGUAL evaluation, must be completed and signed by parent and evaluator. Fax or upload in the Document Submission section at the bottom of this page.
EI Family Assessment Spanish
Prior to conducting an evaluation, must be completed and signed by parent and evaluator. Fax or upload in the Document Submission section at the bottom of this page.
NYTPS EI Supplemental Consent Packet
Prior to conducting a supplemental evaluation, must be completed and signed by parent and evaluator. Fax or upload in the Document Submission section at the bottom of this page.
EI Home Language Survey
Conducted to establish the percentage of bilingualism in the home. Fax or upload in the Document Submission section at the bottom of this page.
NYTPS EI Consent Packet - 2023
Prior to conducting an evaluation, must be completed and signed by parent and evaluator. Fax or upload in the Document Submission section at the bottom of this page.
2. Start Up Forms
All forms needed when starting a new case through NYTPS.
Consent for Alternate signature
Parent authorizes someone else to sign session note and/or service log. Provider to send back to NYTPS with billing.
Consent for the Use of Telehealth - English
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTP.
Consent for the Use of Telehealth - Spanish
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTPS.
Consent to Email and Text - English
Consent from parent/gurardian to exhange information regarding the child via email or text. Complete and fax or upload to NYTPS.
Consent to Email and Text - Spanish
Consent from parent/guardian to exhange information regarding the child via email or text. Complete and fax or upload to NYTPS
Parent/Guardian Consent for Alternate Verification Signature - English
Parent authorizes someone other than themself to sign session notes. Complete and send with billng.
(Suffolk Only) Provider and Family Early Intervention Agreement for Services: English
Agreement advises parent of acceptable professional standards and boundaries. Provider and parent to sign and and send back to NYTPS.
(Suffolk Only) Provider and Family Early Intervention Agreement for Services: Spanish
Agreement advises parent what is acceptable professional standards and boundaries. Provider and parent to sign and send back to NYTPS.
PINS - Personnel In Need Of Supervision Form
This form needs to be completed by CFYs, COTAs, and PTAs, for supervision purposes.
Speech Referral
To be completed for each child on your caseload for each IFSP period.
3. Service Forms
Forms that may need to be completed during the authorization period.
Confirmation of Late Start
To be completed by provider if services start 14 days after the IFSP start date should the case not start on time. Form is submitted online.
Consent for Alternate Verification Signature
Parent/guardian authorizes someone else to sign session note and/or service log. Provider to send back to NYTPS with billing.
Parent/Guardian Consent for Alternate Verification Signature - English
Parent authorizes someone other than themself to sign session notes. Complete and send with billng.
Extended Non-Delivery of Services - LI
To be completed by the provider if the child has more than 3 or more consecutive absences. This form is submited online.
Justification for IFSP Review/Amendment
To be completed by provider if an IFSP review is needed before the end of the authorization period. Complete form and send to the EI department.
Request for Termination of Services
This form is submitted by the provider if services are being terminated. The form is to be submitted online.
Speech Referral
To be completed for each child on your caseload for each IFSP period.
4. Progress Report Template
Complete and either fax or upload through the site. Reports sent via email will not be accepted.
6 Month Progress Report Template
Template can be used for 6 month or discharge reports. Complete and fax to the Early Intervention Department or upload through the site. Emailed Progress will not be accepted.
ABA Team Leader Progress Report
Template can be used for 6 month or discharge reports. Complete and fax to the Early Intervention Department or upload through the site. Emailed Progress will not be accepted.
ABA Team Member Progress Report
Template can be used for 6 month or discharge reports. Complete and fax to the Early Intervention Department or upload through the site. Emailed Progress will not be accepted.
FT ABA Team Leader Progress Report
Template can be used for 6 month or discharge reports. Complete and fax to the Early Intervention Department or upload through the site. Emailed Progress will not be accepted.
Ongoing Service Coordination Report
Template can be used for 6 month or discharge reports. Complete and fax to the Early Intervention Department or upload through the site. Emailed Progress will not be accepted.
NYC/5 Boroughs
1. Start Up Forms
All forms needed when starting a new case through NYTPS.
Consent for Alternate signature
Parent authorizes someone else to sign session note and/or service log. Provider to send back to NYTPS with billing.
Consent for Telehealth - Spanish
Prior to starting telehealth services, must be completed by parent and provider for each service authorization. Complete and fax or upload to NYTPS
Consent to Email and Text - English
Consent from parent/gurardian to exhange information regarding the child via email or text. Complete and fax or upload to NYTPS.
Consent to Email and Text - Spanish
Consent from parent/guardian to exhange information regarding the child via email or text. Complete and fax or upload to NYTPS
Speech Referral
To be completed for each child on your caseload for each IFSP period.
2. Service Forms
Forms that may need to be completed during the authorization period.
Consent for Alternate Verification Signature
Parent/guardian authorizes someone else to sign session note and/or service log. Provider to send back to NYTPS with billing.
Justification for Change
Provider to complete for a change in frequency, duration of medthod of service.
NYC Extended Non-Delivery of Services
To be completed by the provider if the child has more than 3 or more consecutive absences. This form is submited online.
NYC Gap in Services
To be completed by the provider if the child has more than 3 or more consecutive absences. This form is submited online.
Request for Termination of Services
This form is submitted by the provider if services are being terminated. The form is to be submitted online.
Speech Referral
To be completed for each child on your caseload for each IFSP period.
3. Progress Report Template
Complete and either fax or upload through the site. Reports sent via email will not be accepted.
NYC EI Progress Report
Provider to complete EI Progress Report every 6 months.
Progress Report instructions
Instructions to complete NYC EI Rrogress Report.
