Provider Forms

 Client Registration

• Client Registration Form– Updated December 2018 (Word)
• Client Registration Desk Reference– Updated December 2018 (PDF)
• Client Registration Toolkit–  Updated December 2018 (PDF)

Clinical Forms

• Covered Services Authorization Required (PDF)
• Authorization Reference Guide (PDF)
• Critical Incident Report Form (PDF)
• Critical Incident Reporting Procedures (PDF)
• Crisis Alert (PDF)

Handbook – WA Supplement

• Washington State ASO Provider Handbook: Supplemental Appendix (PDF)
• Washington State Medical Necessary Criteria – Updated 2018 (PDF)

ProviderConnect

• ProviderConnect Guides and Tutorials
• Login or register with ProviderConnect, an online tool that allows you to submit and check claims status, check member eligibility, update your provider profile, request inpatient and outpatient authorizations, and more. ProviderConnect is easy to use, secure and available 24/7.
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