Pennsylvania Authorization Forms
Plans administered by Optum behavioral do not require prior authorization for routine outpatient services. Optum administers a wide range of benefits. Select your state to locate the appropriate authorization forms.
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
Mandate
Questions?
Please call the UnitedHealthcare Provider line at 1-888-350-5608 if you need to:
- Contact Optum Behavioral Health clinical or administrative staff
- Request a peer-to-peer review
- Get help if electronic submission via this portal isn’t available