Provider Invoices & Reporting Requirements

• American Behavioral Health Systems Invoice Forms

Required Reports & Timeframes

Monthly

• Data Certification Letter
• SUD Census Report
• SUD Residential Census Report

Quarterly

• Clinician Roster
• Quarterly Update Package
  
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
  

Invoice Form(s)

• Asian Counseling & Referral Services Invoice Forms

Required Reports & Timeframes

Monthly

• CCAP Monthly Report
• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Health Home Due Diligence Report
• Older Adult SUD Services Monthly Performance Report
• Specialty Employment Provider (SEP) Monthly Report
• Specialty Employment Provider (SEP) Supplemental Report (as needed)
  
• WASEC Healthcare Worker Services Program Monthly Report
• Youth Engagement Program (YEP) Monthly Status Report
  

Quarterly

• Clinician Roster
• Contractor Profile Update
• Health Home Quarterly Report
• Specialty Employment Provider (SEP) Quarterly Report
  
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
  
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
  
• Supported Employment Provider (SEP) MIDD (upon request)
• Youth Engagement Program (YEP) Annual Client Profile Report
  

Invoice Form(s)

• Atlantic Street Center Invoice Form

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
  

• Auburn School District Invoice Form

Required Reports & Timeframes

Monthly

• 2019-2020 Auburt SBIRT Financial Report
• ASD Auburn Prevention Coalition Monthly Actual Expenditure Report Form

• Catholic Community Services of Western Washington Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Diversion Interim Housing Monthly Report
• Health Home Due Diligence Report
• Outreach and Engagement at Matt Talbot Center - Monthly Staffing Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Health Homes Quarterly Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
• Individual Vignette for DRS Interim Housing

•  Center for Human Services Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• On-Site Child Care Services Report
• Wraparound/WISe Closures & Staffing Report
• Wraparound/WISe Data Outcome Tool & Caregiver Strain Questionnaire
• Wraparound Flex Fund Request Form
• Wraparound Flex Fund Request Interpreter Form
• Wraparound Flex Fund Request Special Event Form
• Wraparound Monthly Flex Fund Expenditure Report
• Wraparound/WISe Monthly Summary & Training Report
• Youth Diversion Monthly Tracking Report
• Youth Diversion Services Monthly Status Report (to CDS)
• Youth Support Services (YSS) FTE Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Federal Block Grant Quarterly Report
• Quarterly Narrative Report
• Third-Party Payment Report
• YSS Quarterly Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
• Weekly: Wraparound/WISe Referral/Screen Requests, Referrals Source, Enrollees, and Pending List

•  Childhaven Invoice Form

Required Reports & Timeframes

Monthly

• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Therapeutic Child Care Monthly Service Report
• Wraparound/WISe Closures & Staffing Report
• Wraparound/WISe Data Outcome Tool and Caregiver Strain Questionnaire
• Wraparound Monthly Flex Fund Expenditure Report
• Wraparound/WISe Monthly Summary & Training Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
• Current State of Washington Child Care License (for each branch site)
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
• Weekly Reports: Wraparound/WISe Referral/Screen Requests, Referrals Source, Enrollees, and Pending List

• Coalition Ending Gender-Based Violence Invoice Form

Required Reports & Timeframes

Monthly

• DV-BH Services Monthly Staffing Report
• DV-BH System Coordination Monthly Training Report

Quarterly

• Contractor Profile Update

Semi-Annual

• None

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
  
• DV-BH Services Annual Outcomes Report
  

• Community House Mental Agency Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Legal Intervention & Network of Community Care (LINC) Client Record
• LINC Monthly Report Log
• LINC Quarterly Aggregate Data (Monthly Report)
• Long-Term Residential (LTR) Services Reimbursement
• LTR Residential Invoice Report (Client Summary List in Excel Format)
• Supervised Living (SL) Billing Services Reimbursement
• SL Residential Invoice Report (Client Summary List in Excel Format)
• Standard Supportive Housing/Intensive Supported Housing (SSH/ISH) Monthly Report
• Trueblood Client Record

Quarterly

• Clinician Roster
• Contractor Profile Update
• LTR Self-Medication Report
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Consejo Counseling & Referral Services Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Cowlitz Tribal Treatment Invoice Forms

Required Reports & Timeframes

Quarterly

• Tribal Substance Use Disorder Treatment Services
• Mental Health for Children, Adults, Older Adults, and Families

• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Crisis Connections Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Emergency Telephone Services
  • Daily Crisis Log
  • Daily Crisis Log - CC Business Line
  • Daily Crisis Log - CC Crisis Line
  • Crisis Line Wait Time Intervals Monthly Reports
  • Monthly Crisis Line Caller Data Report
  • Next Day Appointment Monthly Report
  • Mobile Crisis Team Monthly Dispatch Report
  • CCPAR Line Volume & Outcomes Report
  • CCPAR Business Line Report
• Patient Placement Coordination
  • PPC Placement Outcomes Summary Report
  • PPC Call Volumes Summary Report
• Telephone Service for Crisis and Commitment Services
  
  • TSCCS Telephone Summary Report (Professional Line Report)
  • TSCCS Triage Summary Report (Public Line Report)
  • Sheena's Law Report
• Warm Line
  • Warm Line Monthly Volunteer Report
  • Warm Line Monthly Call Report
  • Warm Line Profit & Loss Report
  • Warm Line Trial Balance Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Emergency Telephone Services
  • Quarterly Access Report
  • Quarterly Crisis Line Caller Data Report
  • Quarterly CCPAR Crisis Line Report
  • Quarterly CCPAR Business Line Report
• Low-Barrier Buprenorphine
  • Low-Barrier Buprenorphine Treatment Expansion Quarterly Report
• Third-Party Payment Report
• Warm Line
  • Warm Line Quarterly Access Report
  • RH Call Status Report
  • Caller Data Report: Warm Line Quarterly Report
  • Quarterly Reconciliation Report
    

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
• Warm Line
  • Warm Line Yearly Access Report

• Daybreak Youth Services Invoice Forms

Reporting Requirements and Timeframes

Monthly

• SUD Residential Census Report - Youth Intensive Inpatient
• SUD Residential Census Report - Youth Co-Occurring Disorders

Quarterly

• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Domestic Abuse Women's Network Invoice Form

Required Reports & Timeframes

Monthly

• DV-BH Services Monthly Staffing Report
• DV-BH Services Monthly Summary Report
• DV-BH Services MIDD Evaluation Data Report

Quarterly

• Contractor Profile Update

Annual/Other

• Audited Financial Statement
• Certificate of insurance & Endorsement
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
• DV-BH Services Annual Outcomes Report

• Downtown Emergency Services Center Invoice Forms

Required Reports & Timeframes

Monthly

• 1811 Intensive Case Management (ICM) FTE Report
  
• COVID Relief Fund Report
• Crisis Respite Program (CRP) Monthly Report
  
• CRP Monthly Census Log
  
• CRP Referrals Denied Monthly Report
  
• Data Certification Letter
  
• Data & Encounter Submission to the BHRD Management Information System
  
• Homeless Outreach, Stabilization, and Treatment (HOST) Transition Monthly Report
  
• HARPS SUD-Only Subsidy Log
  
• Morrison Housing Report
  
• Peer Pathfinder HMIS Monthly Report
  
• Project for Assistance in Transition from Homelessness (PATH) Monthly Report
  
• Specialty Employment Provider (SEP) Monthly Report
  
• Specialty Employment Provider (SEP) Supplemental Monthly Report (as needed)
• SHARP Caseload Report
  

Quarterly

• 1811 ICM Quarterly Project Narrative Report
  
• Clinician Roster
  
• Contractor Profile Update
• HARPS Participant Log
  
• HARPS Quarterly Report
  
• HOST Quarterly Report
  
• Low-Barrier Buprenorphine Treatment Expansion Quarterly Report
  
• PATH Quarterly Performance Report
  
• Peer Pathfinder Quarterly Implementation Report
  
• Specialty Employment Provider (SEP) Quarterly Report
  
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• CRP Annual Staffing Plan
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
• PATH Annual Report
• SEP MIDD Client Success Stories (as requested)

• Evergreen Healthcare Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Evergreen Recovery Centers Invoice Forms

Required Reports & Timeframes

Monthly

• SUD Residential Census Report
• SUD Withdrawal Management Census Report

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Evergreen Treatment Services Invoice Form

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• MAT Out-of-County Report
• Reentry Case Management Services Staffing Report
• SUD Mobile Medical Van Report
• WASEC Non-Medicaid MAT Program Monthly Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• SUD Mobile Medical Van Evaluation Report
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Excelsior Youth Centers Invoice Form

Required Reports & Timeframes

Monthly

• SUD Residential Census Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Friends of Youth Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Wraparound Contract Monthly Summary
• Wraparound Monthly Flex Fund Expenditures
• Wraparound Flex Fund Request Form
• Wraparound Flex Fund Request Interpreter Form
• Wraparound Flex Fund Request Special Event Form
• Youth Support Services (YSS) FTE Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report
• YSS Quarterly Report
  

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Guided Pathways Invoice Form

Required Reports & Timeframes

Monthly

• Family Support Organization Monthly Progress Report
• FSO MIDD Evaluation Data Report

Quarterly

• TBD

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
• GPS Workplan and Year-End Summary

Invoice Form(s)

• Harborview Allied & Ambulatory Services Invoice Forms

Required Reports & Timeframes

Monthly

• SA-BH Services Monthly Summary Report
• SA-BH Services MIDD Evaluation Data Report
  

Quarterly

• Contractor Profile Update

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
  
• SA-BH Services Annual Outcomes Report
  

• Harborview Behavioral Health Services Invoice Forms
• Harborview Outpatient Mental Health & Addiction Invoice Form

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Emergency Department/Psych Emergency Services Care Manager
  • ED PES Care Manager Monthly FTE Report
  • ED PES Care Manager Monthly Voucher Detail Report
• Involuntary Treatment Triage
  • Involuntary Treatment Triage Monthly Report
• Peer Bridger Program
  
  • Peer Bridger Monthly FTE Report
  • Peer Bridger Monthly Voucher Report
• Screening, Brief Intervention, and Referral to Treatment (SBIRT) Emergency Department Services
  • SBIRT ED Monthly FTE Report
• Specialty Employment Provider (SEP)
  • Specialty Employment Provider (SEP) Monthly Report
  • Specialty Employment Provider (SEP) Supplemental Monthly Report
• Zero Youth Detention
  • Zero Youth Detention IFD Monthly Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Emergency Department/Psych Emergency Services Care Manager
  • ED PES Care Manager Quarterly Log
• Emergency Department Utilization Management (EDUM) Behavioral Health Rapid Response Team
  • A report of activities, trainings, and expenditures in a format approved by the County, if applicable
• Specialty Employment Provider (SEP)
  • Specialty Employment Provider (SEP) Quarterly Report
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
• Involuntary Treatment Triage
  • Involuntary Treatment Triage Monthly Report
• SBIRT Emergency Department Services
  • Provide specific information for the MIDD Annual Report as requested by the County
• Supported Employment Program
  • Provide specific information for the MIDD Annual Report as requested by the County

• The Healing Lodge of the Seven Nations Invoice Form

Required Reports & Timeframes

Monthly

• SUD Residential Census Report - Youth Intensive Inpatient

Quarterly

• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Health Point Invoice Form

Required Reports & Timeframes

Monthly

• COVID FQHC Report

• Hepatitis Education Project Invoice Form

• Hero House Northwest Invoice Forms

Required Reports & Timeframes

Monthly

• Clubhouse Census Report
  
• Consumer-Driven Services Census Log
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Monthly progress note to Outpatient Benefit holder for each enrolled consumer served
• Specialty Employment Provider (SEP) Monthly Report
• Specialty Employment Provider (SEP) Supplemental Report (as needed)

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report
• Specialty Employment Provider (SEP) Quarterly Report
  

Annual/Other

• Annual Report (upon request)
• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
• SEP MIDD (upon request)

• IKRON Invoice Form

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Health Home Due Diligence Tracking Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
  
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Integrative Counseling Services Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submissions to the BHRD Management Information System

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation 
• Disaster Recovery Business Continuity Plan
  
  

• Intercept Associates Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• Interchange Northwest Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report 
• Ombuds Services Monthly Report
• Ombuds Services Monthly Time Sheet

Quarterly

• Grievances & Fair Hearings Quarterly Report
• Ombuds Services Quarterly Telephone Contact Log
• Quarterly Update Package
• Third-Party Payment Report

• Ombuds Service Semi-Annual Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Disaster Recovery Business Continuity Attestation 
• Disaster Recovery Business Continuity Plan

• International Community Health Services Invoice Form

Required Reports & Timeframes

Monthly

• COVID FQHC Report

• Kent Youth & Family Services Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report 
• Youth Diversion Services Tracking Report
• Youth Support Services FTE Report

Quarterly

• Contractor Profile Update

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan

• King County Sexual Assault Resource Center Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report 
• SA-BH Services Monthly Summary Report
• SA-BH Services MIDD Evaluation Data Report

Quarterly

• Contractor Profile Update
  

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation 
• Disaster Recovery Business Continuity Plan
  
• SA-BH Services Annual Outcomes Report
  

• LifeWire Invoice Form

Required Reports & Timeframes

Monthly

• DV-BH Services Monthly Staffing Report
• DV-BH Services Monthly Summary Report
• DV-BH Services MIDD Evaluation Data Report
  

Quarterly

• Contractor Profile Update
  

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
  
• DV-BH Services Annual Outcomes Report
  

• Lutheran Community Services NW Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report

• Metropolitan Development Council Invoice Form

Required Reports & Timeframes

Monthly

• Evaluation & Treatment Census Report
• Withdrawal Management Census Report

Quarterly

• Contractor Profile Quarterly Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)

• Muckleshoot Indian Tribe Invoice Forms

Required Reports & Timeframes

Monthly

• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Contractor Profile Quarterly Update
• Mental Health for Children, Adults, Older Adults, and Families
• Tribal Substance Use Disorder Treatment Services

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation 
• Disaster Recovery Business Continuity Plan
  

• Multicare Behavioral Health Invoice Form

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report

• NAMI Eastside Invoice Forms

Required Reports & Timeframes

Monthly

• TBD

• NAMI Seattle Invoice Form

Required Reports & Timeframes

Monthly

• KC Consumer Training Fund Monthly Expenditures

Quarterly

• Contractor Profile Update

Semi-Annual

• KC Consumer Training Fund Semi-Annual Status Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
  
• Closure Dates Report
  
• KC Consumer Training Fund Conference & Seminar Approval List Annual Report
  

• NAMI South King County Invoice Form

Required Reports & Timeframes

Monthly

• TBD

• Navos Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Fund Relief Form
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• HARPS Housing Bridge Subsidy
• ICSRP Monthly Census Log
• ICSRP Monthly Engagement Log
• LTR Billing Report
• PACT Monthly Report
• Peer Bridger Monthly Staffing Report
• Peer Bridger Monthly Voucher Report
• Residential Invoice Report
• SEP Supplemental
• SSH Report

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• LTR Self-Medication Report
• Third Party Payment Report

Semi-Annual

• PACT Transition Assessment Scale

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation 
• Disaster Recovery Business Continuity Plan

• Neighborcare Health Center Invoice Form

Required Reports & Timeframes

Monthly

• COVID FQHC Report

• Neighborhood House Invoice Form

Required Reports & Timeframes

Monthly

• NEH PEACE Monthly Actual Expenditure Report Form
• Minerva Monthly Report

Quarterly

• Minerva Monthly Report

• New Beginnings Invoice Form

Required Reports & Timeframes

Monthly

• DV-BH Services Monthly Staffing Report
• DV-BH Services Monthly Summary Report
• DV-BH Services MIDD Evaluation Data Report

Quarterly

• Contractor Profile Update
  

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
• Disaster Recovery Business Continuity Attestation
• Disaster Recovery Business Continuity Plan
  
• DV-BH Services Annual Outcomes Report
  

• New Horizon Care Centers Invoice Forms

Required Reports & Timeframes

Monthly

• SUD Residential Census Report

Quarterly

• Contractor Profile Quarterly Update

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Disaster Recovery Business Continuity Attestation 
• Disaster Recovery Business Continuity Plan

• New Traditions Invoices Form

Required Reports & Timeframes

Monthly

• Monthly Pregnant & Parenting Women (PPW) & Child Care Report
• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)

• Northwest Ambulance Invoice Form

Required Reports & Timeframes

Monthly

• Court Times Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report

• Olalla Recovery Centers Invoice Form

Required Reports & Timeframes

Monthly

• SUD Residential Census Report - Adult Intensive Inpatient

Quarterly

• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Disaster Recovery Business Continuity Plan Update

•  Oxford House Invoice Form

Required Reports & Timeframes

Monthly

• Rapid Re-Housing FTE Report
• Rapid Re-Housing Monthly Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)

• Pioneer Human Services Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Diversion and Reentry Services Care Coordination
• HARPS Housing Bridge Subsidy
• HARPS Participant Log
• Housing Services for King County Regional Mental Health Court
• PACT Monthly Report
• PACT Transition Assessment Scale
• SUD Assessments - Therapeutic Courts & Jail Health Release Planning
• SUD Residential Census Report
• Sobering Adult CM CDI Report
• TRP Monthly Data Log

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• PACT Quarterly Report
  
• Third Party Payment Report

Semi-Annual

• PACT Transition Scale

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)

• Puget Sound Education Service District Invoice Forms

Required Reports &Timeframes

Monthly

• CDFY Monthly Actual Expenditure Report Form
• SB SBIRT CPWI Pilot Project Monthly Report
• Minerva Monthly Report

Quarterly

• Minerva Quarterly Report

• Recovery Cafe Invoice Forms

Required Reports & Timeframes

Monthly

• New Recovery Cafe Development Costs
• SOR Recovery Support Services Opiate Use Disorder Billing Summary
• SOR Recovery Support Services Substance Use Disorder Billing Summary
• Substance Use Disorder Peer Recovery Services Monthly FTE Report
• WASEC Recovery Supports Systems Program Monthly Report

Quarterly

• Contractor Profile Quarterly Update

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)

• Recovery Innovations Invoice Forms

Required Reports & Timeframes

Monthly

• Admission-Denial Log
• E&T Census Report
• IRT Census Report
• Seclusion & Restraint Report

Quarterly

• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)

• Refugee Women's Alliance Invoice Form

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• DV-BH Services Monthly Staffing Report
• DV-BH Services Monthly Summary Report
• DV-BH Services MIDD Evaluation Data Report
• Monthly Interpreter Detail

Quarterly

• Contractor Profile Update
  

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
  
• DV-BH Services Annual Outcomes Report
  

• Ryther Center Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Health Homes
  • Health Homes Due Diligence Report
  • Juvenile Justice Assessment Team (JJAT)
• Medication-Assisted Treatment (MAT)
  • Co-pay Deductible Report (as funding is available)
  • MAT Out-of County Report
• New Journeys Demonstration Project
  • New Journeys Demonstration Project Monthly Report
• Outstation/Recovery School Youth Support Services (YSS)
  • YSS FTE Report

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• Health Homes
  • Health Homes Quarterly Report
• New Journeys Demonstration Project
  • New Journeys Demonstration Project Quarterly Reconciliation Report
• YSS Quarterly Report
• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)
• Health Homes

• Saint Anne Hospital Invoice Form

Required Reports & Timeframes

Annual/Other

•  SBIRT ED FTE Report

• Saint Francis Hospital Invoice Form

Required Reports & Timeframes

Annual/Other

•  SBIRT ED FTE Report

• Seadrunar Center Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• SUD Residential Census Report
  
• Withdrawal Management with Linkages to Treatment - Census Report

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)

• Sea Mar Community Health Centers Invoice Forms

Required Reports & Timeframes

Monthly

• COVID FQHC Report
• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• SUD Residential Census Report
  

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
  
• Disaster Recovery Business Continuity Plan Update(s)

• Seattle Children's Invoice Form

Required Reports & Timeframes

Monthly

• COVID FQHC Report

• Seattle Counseling Services Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• HASAP Quarterly Evaluation Report
• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)
• Participate in County's Annual Report to DBHR for HASAP

• Seattle Indian Health Board Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submissions to the BHRD Management Information System
• SUD Residential Census Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)

• Seattle Public Schools Invoice Forms

Required Reports & Timeframes

Monthly

• Minerva Monthly Report
• Seattle SBIRT Financial Report
• SPS HYCAN Monthly Actual Expenditure Report Form
• YSS FTE Report

Quarterly

• Minerva Quarterly Report
• YSS Quarterly Report

• Seneca Family of Services Invoice Form

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
  
• Disaster Recovery Business Continuity Plan Update(s)

• Snoqualmie Indian Tribe Invoice Forms

Required Reports & Timeframes

Monthly

• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Contractor Profile Quarterly Update
• Mental Health for Children, Adults, Older Adults, and Families
• Tribal Substance Use Disorder Treatment Services

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report

• Sound Invoice Forms

Required Reports & Timeframes

Monthly

• Adult Crisis Services Report
• Assisted Outpatient Services Program
• Benson Heights Monthly Report
• CDVRT Monthly Summary Report
• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Long-Term Rehabilitation Services Billing Report Services Monthly Summary
• Long-Term Rehabilitation Services Residential Invoice Report
• Path Monthly Report
• Reaching Recovery
  • FIRST Report
  • ORCS Report
  • Reaching Recovery Housing Monthly Log
• Specialty Employment Provider (SEP) Monthly Report
• Specialty Employment Provider (SEP) Supplemental Monthly Report
• South King County Housing First Monthly Move-In Report
• South King County Housing First Monthly Move-Out Report
• Standard Supportive Housing Monthly Report
• STAR Program Monthly Status Report
• SUD Outpatient Monthly Transportation Back-up (as needed)
• Transition Support Program Linkage Report
• Transition Support Program Monthly Staffing Report
• Wraparound Contract Monthly Summary
• Wraparound Flex Fund Request Form
• Wraparound Flex Fund Request Interpreter Form
• Wraparound Flex Fund Request Special Event Form
• Wraparound Monthly Flex Fund Expenditures Report

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• LTR Self-Medication Quarterly Report
• PATH Quarterly Report
• PATH Quarterly Report
• Reaching Recovery Consumer Recovery Measure (for all program participants)
• Reaching Recovery Marker Inventory (for all program participants)
• Specialty Employment Provider (SEP) Quarterly Report
• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)

• Specialty Services II Invoice Form

Required Reports & Timeframes

Monthly

• SUD Census Report
• SUD Residential Census Report

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)

• Spokane Addiction Recovery Centers Invoice Forms

Required Reports & Timeframes

Monthly

• SUD Residential Census Report

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Disaster Recovery Business Continuity Plan Update(s)

• Tacoma-Pierce County Health Department Invoice Form

Required Reports & Timeframes

Monthly

• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Closure Dates Report
  
• Disaster Recovery Business Continuity Plan Update(s)

• Telecare Invoice Form

Required Reports & Timeframes

Monthly

• Discharge Planner Report
• E&T Admission/Denial Log
• E&T Census Report
• Seclusion & Restraint Report

Quarterly

• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)

• Therapeutic Health Services Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• MAT Out of County Report
• MST FTE Report
• MST Monthly Status Report
• PPW Monthly Report
• SBIRT Monthly Staffing Report
• YEP Monthly Status Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
  
• Disaster Recovery Business Continuity Plan Update(s)
• MST Annual Client Profile Report
• YEP Annual Client Profile Report
  

• Transitional Resources Invoice Forms

Required Reports & Timeframes

Monthly

• Adult Inpatient Diversion Bed Monthly Report
• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Long-Term Residential Monthly Billing Report Services
• Long-Term Residential Monthly Residential Invoice Monthly Report

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• Long Term Rehabilitation Services Self-Medication Quarterly Report
  
• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)

• Triumph Treatment Services Invoice Forms

Required Reports & Timeframes

Monthly

• SUD Residential Census Report & MAT Log

Quarterly

• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Disaster Recovery Business Continuity Plan Update(s)

• Valley Cities Counseling & Consultation Invoice Forms

Required Reports & Timeframes

Monthly

• Adult Crisis Services Log
• COVID Relief Fund Report
• Data Certification Letter
• Health Home Due Diligence Tracking
• Mental Health First Aid (MHFA) FTE Report
• Mental Health First Aid (MHFA) Monthly Performance Report
• New Journeys Demonstration Project
• Specialty Employment (SEP) Monthly Report
• Specialty Employment (SEP) Monthly Report - Part 1 Outcomes
• Standard Supportive Housing Rental Assistance
• SUD Residential Census Report
• SUD Census Report - Withdrawal Management with Linkages to Treatment
• Wraparound Flex Fund Request Form
• Wraparound Flex Fund Request Interpreter Form
• Wraparound Flex Fund Special Event Form
• Wraparound Monthly Flex Fund Expenditures Report
  

Quarterly

• Clinician Roster
• Contractor Profile Quarterly Update
• Low-Barrier Buprenorphine Treatment Expansion Quarterly Report
• Specialty Employment Provider (SEP) Quarterly Report
• Third Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)

• Vashon Youth & Family Services Invoice Form

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
  
• Disaster Recovery Business Continuity Plan Update(s)

• WAPIFASA Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• Youth Support Services FTE Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Quarterly Narrative Report
• Third-Party Payment Report
• YSS Quarterly Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report

• WCHS Invoice Form

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submission to the BHRD Management Information System
• MAT Out of County Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
  
• Disaster Recovery Business Continuity Plan Update(s)

•  YMCA Invoice Forms

Required Reports & Timeframes

Monthly

• Children's Crisis Outreach Response System (CCORS) Monthly Summary
• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submissions to the BHRD Management Information System
• ISS Master Client List
• TRACE Monthly Narrative
• Wraparound Monthly Flex Fund Expenditure Report
• Wraparound/WISe Monthly Summary & Training Report
• Young Adult Outreach Response System Monthly Summary
• Youth Connection Services Monthly Service/System Coordination Summary

Quarterly

• CCORS Quarterly Mental Health Block Grant Costs & Revenue Summary
• Clinician Roster
• Contractor Profile Update
• ISS Quarterly Data Summary Report
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)
• Weekly Reports: Wraparound/WISe referral/screen requests, referrals source, enrollees, and pending list

• You Grow Girl Invoice Forms

• Youth Eastside Services Invoice Forms

Required Reports & Timeframes

Monthly

• COVID Relief Fund Report
• Data Certification Letter
• Data & Encounter Submissions to the BHRD Management Information System
• Monthly Status Report ot CDS
• Youth Diversion Monthly Tracking Report

Quarterly

• Clinician Roster
• Contractor Profile Update
• Third-Party Payment Report

Annual/Other

• Audited Financial Statement
• Certificate of Insurance & Endorsement
• Client Success Stories (upon request)
• Closure Dates Report
• Disaster Recovery Business Continuity Plan Update(s)