Mental Health Therapy Prior Authorization Request Form

Simplify Mental Health Prior Authorization with Paperform

Submitting prior authorization requests for mental health therapy services doesn't have to mean drowning in paperwork and fax machines. This Mental Health Therapy Prior Authorization Request Form template helps therapists, counselors, psychiatrists, and mental health practices capture all the essential information insurance companies require—patient demographics, DSM-5 diagnoses, treatment goals, session frequency, and provider credentials—in a single, professional digital form.

Built specifically for mental health professionals navigating the insurance authorization process, this template ensures you include clinical justifications, diagnostic codes, and treatment plans that meet payer requirements. Whether you're requesting authorization for individual therapy, group sessions, or intensive outpatient programs, you can customize the form to match different insurance carriers' specific documentation needs.

Paperform's conditional logic lets you show or hide fields based on diagnosis type or treatment modality, ensuring clinicians only see relevant questions. Once submitted, you can route requests to billing coordinators, automatically generate follow-up emails to insurance companies, or log submissions in your practice management system.

For practices handling high volumes of authorization requests, connect this form to Stepper to automate your entire prior auth workflow—send submission confirmations to providers, create tracking tasks in your project management tool, set reminders for follow-ups, and notify patients once authorization is approved. You can even integrate with your EHR system via webhook to keep clinical and billing teams in sync.

With Papersign at papersign.com, you can pair authorization requests with patient consent forms or treatment agreements, keeping all documentation connected and audit-ready in one place.

This template is ideal for individual practitioners, group practices, community mental health centers, and behavioral health organizations that want to reduce authorization delays, minimize claim denials, and spend less time on insurance paperwork and more time providing care.