Get the free Combined Behavioral Health Provider and PCP Communication Form

Combined Behavioral Health Provider/Primary Care Provider Communication Form If you are unsure of the patients assigned PCP, for Medicaid please contact Harmony Customer Service Department at 18006088158

How to fill out combined behavioral health provider

How to fill out combined behavioral health provider

1. Provide the necessary personal and contact information of the patient
2. List all the mental health conditions and behavioral issues of the patient
3. Include any previous treatment or therapy records of the patient
4. Specify the desired type of therapy or treatment for the patient
5. Provide any relevant medical history or medication information of the patient
6. List any specific concerns or goals for the therapy or treatment
7. Include any insurance or payment information if applicable
8. Submit the completed combined behavioral health provider form to the relevant healthcare provider

Who needs combined behavioral health provider?

1. Individuals experiencing mental health disorders such as depression, anxiety, bipolar disorder, schizophrenia, etc.
2. Individuals with behavioral issues or addictive behaviors
3. People seeking therapy or treatment for substance abuse
4. Individuals who require a holistic approach to mental and emotional well-being
5. Patients who need integrated care for both mental and physical health conditions
6. People in need of comprehensive assessment, diagnosis, and treatment planning for behavioral health issues
7. Individuals who want a coordinated approach to mental health and substance abuse treatment

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