Chemical Dependency Contract Billing
Instructions and Forms
Ancillary Services Forms
- Ancillary Services "How To" Instructions (MS Word)
- Ancillary Services Billing Form Sample (Excel)
- Frontier Ancillary Billing Correction Form (Excel)
- Frontier Ancillary Billing Form (Excel)
- Frontier Ancillary Billing Supplemental Form (Excel)
- Urban Ancillary Billing Correction Form (Excel)
- Urban Ancillary Billing Form (Excel)
- Urban Ancillary Billing Supplemental Form (Excel)
Community-Based Residential
- CB Residential Billing Form (Excel)
- CB Billing Correction Form (Excel)
- CB Billing Form Sample (Excel)
- Community-Based Residential 'How To' Instructions (MS Word)
Co-Occurring
- Co-Occurring Billing Correction Form (Excel)
- Co-Occurring Billing Form (Excel)
- Co-Occurring Billing Form Sample (Excel)
- Co-Occurring Billing Supplemental Form (Excel)
- Co-Occurring "How To" Instructions (MS Word)
Day Treatment
- Day Treatment Billing Form (Excel)
- Day Treatment 'How To' Instructions (MS Word)
- Day Txt Billing Correction Form (Excel)
- Day Txt Billing Form Sample (Excel)
- Day Txt Billing Supplemental Form (Excel)
Inpatient Residential Forms
- Inpatient Residential Billing Correction Form (Excel)
- Inpatient Residential Billing Form (Excel)
- Inpatient Residential Billing Form Sample (Excel)
- Inpatient Residential Billing Supplemental Form (Excel)
- Inpatient Residential 'How To' Instructions(MS Word)
MTUPP Grant
Prevention
Shelter Care
- Shelter Care Billing Correction Form (Excel)
- Shelter Care Billing Form (Excel)
- Shelter Care Billing Form Sample (Excel)
- Shelter Care 'How To' Instructions (MS Word)
Urban Outpatient & Frontier Outpatient
- Frontier Outpatient Billing Correction Form (Excel)
- Frontier Outpatient Billing Form (Excel)
- Frontier Outpatient Billing Supplemental Form (Excel)
- Outpatient Billing Form Sample (Excel)
- Outpatient 'How To' Instructions (MS Word)
- Urban Outpatient Billing Correction Form (Excel)
- Urban Outpatient Billing Form (Excel)
- Urban Outpatient Billing Supplemental Form (Excel)
If you have any questions or concerns regarding these instructions or billing forms, please contact Danielle Murphy via email or by phone (406) 444-9304.
Page last updated: 12/14/2007
