Provider Forms
Authorizations Forms
Authorization Request Form (ARF) - Handwritten - Page 1
.pdf format
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MS Word Format
March 2008
Authorization Request Form (ARF) - Handwritten - Page 2
.pdf format
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MS Word Format
March 2008
Authorization Request Form (ARF) - Electronic - Page 1
MS Word Format
March 2008
Authorization Request Form (ARF) - Electronic - Page 2
MS Word Format
March 2008
Authorization Request Form (ARF) - Psychiatric
.pdf format
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MS Word Format
March 2008
Authorization Request Form (ARF) Instructions
.pdf format
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MS Word Format
February 2007
CSS Beyond Limits of Benefit Plan-Adult
.pdf format
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MS Word Format
September 2008
CSS beyond limits of Benefit Plan-Child
.pdf format
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MS Word Format
September 2008
How to Personalize your Electronic ARF
.pdf format
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MS Word Format
Level I Diagnoses
MS Excel format
December 2008
Level II Diagnoses
MS Excel format
December 2008
OPC Adult MH IPRS Benefit Plan Level I
.pdf format
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MS Word Format
December 2008
OPC Adult MH IPRS Benefit Plan Level II
.pdf format
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MS Word Format
December 2008
OPC Adult SA IPRS Service Benefit Plan
.pdf format
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MS Word Format
December 2008
OPC Adult SA IPRS Service Benefit Plan
.pdf format
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MS Word Format
July 2008
OPC Child MH IPRS Service Benefit Plan
.pdf format
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MS Word Format
December 2008
OPC Child SA IPRS Service Benefit Plan
.pdf format
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MS Word Format
August 2008
OPC Developmental Disabilities Authorization Form
.pdf format
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MS Word Format
April 2008
OPC DD Flex Fund Application
.pdf format
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MS Word Format
April 2008
OPC DD Flex Fund Brochure
.pdf format
April 2008
OPC Level of Care Criteria
.pdf format
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MS Word Format
June 2006
Request for Room & Board
.pdf format
May 2008
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