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2020 Behavioral Health Authorization Notification Form 508

2020 Behavioral Health Authorization Notification Form 508-2025

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The document is a Behavioral Health Authorization/Notification Form from Molina Healthcare of Washington, used for requesting authorization for various mental health and substance use disorder services. It includes sections for member and provider information, service request types, required clinical documentation, and specific treatment procedures that necessitate prior authorization or notification. The form outlines the necessary details to ensure proper processing of requests related to behavioral health services.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (80 Votes)

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