Harmony Behavioral Health, Inc. (HBH) is a Florida-based, URAC Accredited, managed behavioral health care organization that provides a full range of innovative, comprehensive and value-oriented mental health and substance abuse services through a network partnership of public and private stakeholders for the WellCare Group of Companies: HealthEase, StayWell and WellCare that include benefits for Medicaid, Healthy Kids, and Medicare. HBH currently manages 525,000 members in Florida including about 400,000 Medicaid and SCHIP enrollees and 60,000 Medicare enrollees.

Forms 

	Letter of Intent  If you are not currently a participating provider, but would like to join the Harmony Behavioral Health network, download and complete this form and fax to: (813)262-2982.
	W-9  IIf you would like to become a participating provider in the Harmony Behavioral Health network or if you need to update your provider tax information, you are required to complete the W-9 IRS tax form.
	HBH Preferred Drug List The Harmony Behavioral Health Preferred Drug List contains a list of preferred behavioral health medications for Staywell and HealthEase (Florida Medicaid) health plan members.
	Change of Provider Information If you need to change your office or billing address, telephone or fax number, or correct other provider information, download and complete this form, and fax to: (BH-Provider Relations).
	Pharmacy Drug Evaluation Form This form is used by participating providers to obtain coverage for a drug for which there is medical criteria protocol established by the Pharmacy & Therapeutic Committee at WellCare Health Plans.
	Treatment Plan Update If you are required to provide updated clinical information to substantiate a request for continuation of behavioral health treatment for a health plan member, download and complete this form, and fax to: (866) 517-5835.
	Enhanced Services Request Form If you are requesting enhanced behavioral health services for a health plan member, please download and complete this form. Fax the completed form to: (866) 517-5835.
	Enhanced Services Request Supplement If you are requesting enhanced behavioral health services for a health plan member, please download and complete this form with any additional clinical information that will assist us in determining medical necessity for the requested services. Fax the completed form to: (866) 517-5835.
	Harmony Behavioral Health Provider Manual Provides a handy reference for behavioral health providers.
	Authorization Guidelines  Provides general guidelines regarding covered services requiring prior authorization.