Optum Standard Authorization Forms

Plans administered by Optum behavioral do not require prior authorization for routine outpatient services. Optum administers a wide range of benefits.

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

Transcranial Magnetic Stimulation (TMS) & Electroconvulsive Therapy (ECT) Forms

TMS & ECT Authorization Request Form (NEW) - electronic submission

For more information regarding United Healthcare Community and State Rhode Island Medicaid and Optum Behavioral Health Prior Authorization and Notifications, please click here.