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Psychological Testing Request Form - Providers Amerigroup

Psychological Testing Request Form - Providers Amerigroup 2025

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The document outlines the process for requesting authorization for psychological testing through Amerigroup. It specifies that formal psychological testing is not typically indicated for routine behavioral health assessments and emphasizes the need for prior diagnostic interviews and relevant rating scales. The document includes sections for providing member information, clinical assessments completed, symptoms necessitating testing, treatment history, administered rating scales, previous testing details, diagnoses, rationale for testing, and a request for specific psychological tests.

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