Network180 - FY17 1/12th Payments and Encounter Submission SUD ARB - Arbor Circle 1) SA Family Engagement 132262 ARB Family Engagement 9397 H0004 $12,398.00 Month 132262 ARB Family Engagement 9397 H0004 $13,018.00 Month 132262 ARB Family Engagement 9398 90832 $933.00 Month 132262 ARB Family Engagement 9398 90832 $980.00 Month 132262 ARB Family Engagement 9399 H0006 $10,026.00 Month 132262 ARB Family Engagement 9399 H0006 $10,527.00 Month 132262 ARB Family Engagement 9404 H0038 $9,740.00 Month 132262 ARB Family Engagement 9404 H0038 $10,227.00 Month 132262 ARB Family Engagement 9402 88059 $5,000.00 Month 132262 ARB Family Engagement 9402 88061 $16,200.00 Month 03/31/2017 H0006-1 Unit 09/30/2017 H0006-1 Unit 03/31/2017 H0038-1 Unit 09/30/2017 H0038-1 Unit 09/30/2017 No 09/30/2017 No
9397 H0004 9397 H0005 9398 90846 9398 90847 9398 90853 9398 97810 9399 H0006 9404 H0038 2) Kent County Correctional Facility 132216 ARB KC Corrections 9396 H0015 $14,139.00 Month 132216 ARB KC Corrections 9396 H0015 $14,846.00 Month 132216 ARB KC Corrections 9397 H0004 $471.00 Month 132216 ARB KC Corrections 9397 H0004 $495.00 Month 132216 ARB KC Corrections 9398 90832 $1,100.00 Month 132216 ARB KC Corrections 9398 90832 $1,155.00 Month
9396 H0015 9398 90832 9398 90834 9398 90837 9398 90846 9398 90847 9398 90853 9398 97810 3) North County Outreach 132449 ARB North County 9397 H0004 $491.00 Month 132449 ARB North County 9397 H0004 $516.00 Month 132449 ARB North County 9398 90832 $4,974.00 Month 132449 ARB North County 9398 90832 $5,223.00 Month
9397 H0005 9398 90846 9398 90847 9398 90853 9398 97810 4) Second Chance Valued Community Member 132260 ARB Second Chance 9397 H0004 $667.00 Month 132260 ARB Second Chance 9397 H0004 $700.00 Month 132260 ARB Second Chance 9398 90832 $12,664.00 Month 132260 ARB Second Chance 9398 90832 $13,297.00 Month 132260 ARB Second Chance 9405 H0050 $9,740.00 Month 132260 ARB Second Chance 9405 H0050 $10,227.00 Month 132260 ARB Second Chance 9402 88067 $5,000.00 Month 03/31/2017 H0050-1 Unit 09/30/2017 H0050-1 Unit 09/30/2017 No
9397 H0005 9398 90832 9398 90834 9398 90837 9398 90846 9398 90847 9398 90853 9398 97810 9405 H0050 5) Enhanced Women's Services 132266 ARB ENH Women's Services 9404 H0038 $9,740.00 Month 132266 ARB ENH Women's Services 9404 H0038 $10,227.00 Month 132266 ARB ENH Women's Services 9402 88075 $4,500.00 Month 03/31/2017 H0038-1 Unit 09/30/2017 H0038-1 Unit 09/30/2017 No 9404 H0038 6) Shelter Treatment Collaborative
132261 ARB Shelter Treatment 9396 H0015 $3,909.00 Month 132261 ARB Shelter Treatment 9396 H0015 $4,104.00 Month 132261 ARB Shelter Treatment 9397 H0004 $651.00 Month 132261 ARB Shelter Treatment 9397 H0004 $684.00 Month 132261 ARB Shelter Treatment 9398 90832 $8,473.00 Month 132261 ARB Shelter Treatment 9398 90832 $8,897.00 Month 9396 H0015 9398 90832 9398 90834 9398 90837 9398 90846 9398 90847 9398 90853 9398 97810 7) Drug Court Seeking Safety
132264 ARB Seeking Safety 9401 90853 $420.75 Month 132264 ARB Seeking Safety 9401 H0038 $1,217.50 Month 132264 ARB Seeking Safety 9401 H0038 $1,278.00 Month 09/30/2017 90853-1 Unit 03/31/2017 H0038-1 Unit 09/30/2017 H0038-1 Unit 9401 90853 9401 H0038 8) Recovery Management Services 132259 Management 9397 H0004 $6,352.00 Month 132259 Management 9397 H0004 $6,670.00 Month 132259 Management 9400 H0050 $4,870.00 Month 132259 Management 9400 H0050 $5,114.00 Month 132259 Management 9402 88061 $16,200.00 Month 09/30/2017 No
9397 H0004 9397 H0005 9400 H0038 9400 H0050 9) For all Non-consumer specific claims not mentioned above, Use consumer Id 132353 (ARB Non Consumer). A list of these billing codes are specified below. Please refer to Network180 Allowable Services report for further details. Please follow your provider manual to determine when these can be billed. 88055 88059 88067 88901 88902 88904