Louisiana Authorization Forms
Plans administered by Optum behavioral do not require prior authorization for routine outpatient services. If you need authorization for any of the following services, please select the link below:
ABA Assessment & Treatment Plan Forms
- ABA Assessment Requests - electronic submission (commercial ABA providers only)
- ABA Treatment Plan - electronic submissions
Psychological Testing Request Forms
- Optum Psych Testing Request Form - electronic submission
- Medica Psych Testing Request Form
Transcranial Magnetic Stimulation (TMS)
- TMS Prior Authorization Request Process Training
All Other Non-Routine Services- Louisiana Electronic Submission Form – Commercial providers only