Information for Providers

Below you will find forms, policies, and resources for TMBH-ASO Network Providers. 

Forms and Checklists

Non-crisis behavioral health services request forms. Prior to the initiation of any type of non-crisis behavioral health service, once the individual has been identified as Medicaid ineligible, a Non-Medicaid Request Form , or a Non-Medically Necessary Request Form (for services which medical necessity does not apply), and the Thurston-Mason BH-ASO Non-Medicaid Services Form must be completed and submitted, in an editable format, via an encrypted email to



SUD residential and withdrawal management contractors shall ensure the minimal data elements for admission, utilization review/continued stay, and discharge are reported to Thurston-Mason BH-ASO for all individuals pre-authorized (using the Non-Medicaid Request and TMBH-ASO Non-Medicaid Services forms). These data elements must be submitted via an encrypted email to using the following forms:


Thurston Mason BH-ASO Policies

Notices to Providers