Authorization Request

Providers are required to request authorization before providing services. Tejas uses information provided on the forms available below to determine if a service is appropriate.

The authorization requests evaluate of the appropriateness, medical need and efficiency of health care service procedures and facilities according to established criteria or guidelines and under the provisions of an applicable health benefits plan.

Typically it includes new activities or decisions based on the analysis of a situation. Proactive procedures are described, including discharge planning, concurrent planning, pre-authorization and clinical case appeals. It also covers proactive processes, such as concurrent clinical reviews and peer reviews, as well as appeals introduced by the provider, payer or member.

Authorization Request Forms

Outpatient Treatment Record PDF Document

Request for Psychological Testing PDF Document

Submit Forms

Please submit completed forms to: Tejas Behavioral Health Services, Utilization Review

Fax:
512-703-1394

Mail:
P.O. Box 3548
Austin, TX 78764-3548