2003-Senate Bill 123 Monthly Insurance Report Form Packet effective November 1, 2007

Letter to Treatment Providers

• Letter to Treatment Providers concerning Insurance Report Form

Procedure to Treatment Providers on Insurance

• Procedure for Treatment Providers to follow to submit Insurance

Instructions for Completing Monthly Insurance Report Form

• Instructions for Completing the 2003-SB 123 Monthly Insurance Report Form

Treatment Provider Monthly Insurance Report Form

• Treatment Provider Monthly Insurance Report Form