Thurston Mason Behavioral Health Administrative Service Organization

612 Woodland Square Loop SE 

Suite 401

Lacey, WA 98503

inquiries@tmbho.org

Office: 360-763-5828

Crisis Line:  800-270-0041

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 oprequest@tmbho.org.

 

 

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 iprequest@tmbho.org using the following forms:

 

Thurston Mason BH-ASO Policies

Notices to Providers