The LCC Reference Manual for treatment providers provides guidelines for treatment service definitions, requirements and restrictions, and is a reference source for issues relating to treatment activities funded through LCC. The Lakeshore Coordinating Council Medicaid Provider Guidelines are designed to assist participating providers. Client fees are based on a sliding fee scale.
Financial Report Forms Blank Financial Status Report Form LCC Cost Study Report LCC Supplemental Cost Information by Service Category Form LCC Declaration of Income Application for Benefits Form Performance Reporting Forms LCC Waiting List Reporting Form LCC Performance Indicator Consumer Satisfaction Report Background Info for LCC Advisory Committee Review Request Forms LCC Treatment Extension Request Form LCC Non Region Resident Application LCC Training Reimbursement Request Application LCC CareNet Data Correction Request Form LCC Uniform Billing Adjustment Form LCC Request for Review of AAR Authorization Decision LCC Carenet Password Request Form Staff Related Forms LCC Program Verification of Staff Credentials Form LCC Internship Form LCC Provider Communicable Disease Staff Training Log LCC Clinical Application Form
MAFE Registration Form