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Hawaii 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 

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

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

Hawaii DSNP and Medicaid Authorization Request Form