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Chemical Dependency Provider Manual

  • Administration Section

  • Chemical Dependency Contract Billing
    This page link is currently unavailable while the billing instructions and forms are being updated. Should you need forms, please contact your AMDD CD Program Officer to obtain the correct forms. New forms will be posted as soon as they are available.

  • Forms

  • Program Section

 

Administration Section

  1. Program Information
  2. Billing Procedures
  3. Program Requirements
  4. County Plans
  5. Client Eligibility
  6. State Approval Process

 

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Forms

  1. County Plan
  2. Financial
    1. Adolescent Quarterly Billing – Frontier Rates
    2. Adolescent Quarterly Billing – Urban Rates
    3. Adults – Quarterly Billing – Frontier Rates
    4. Adults – Quarterly Billing – Urban Rates
    5. Financial Intake Form
    6. Sample Master Client
    7. Sample Master Client Quarterly Sheet
  3. Prior Authorization
    1. Prior Authorization - Day
      1. Notification of Day Treatment
      2. Request for Continued Stay
      3. Request for Prior Authorization
    2. Prior Authorization - Residential
      1. Notification of Bed Date
      2. Request for Continued Stay
      3. Request for Prior Authorization
    3. Prior Authorization - Shelter
      1. Notification of Shelter Day
      2. Request for Continued Stay
      3. Request for Prior Authorization
  4. Quality Assurance
  5. Special Project Requests
  6. Yearly Applications

 

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Program Section

01  ACT
02  Assessment
03  Case Management
04  Family Therapy
05  Ancillary
06  Group Therapy
07  Individual Therapy
08  Monitoring
09  Inpatient Residential
10  Inpatient Day Treatment
11 Transitional Living
12 Recovery Homes
13 Women and Children
14 School-Based Intervention Services
15 Adolescent Residential
16 Minor In Possession
17 Prevention
18 Co-Occurring

Page last updated: 10/03/2011