Find a Provider

To find a Parkland Community Health Plan doctor, use the interactive search tool, or you can view the PDF versions of the directory. These PDF versions are updated monthly.

Call our Member Services department Monday - Friday from 8 am to 5 pm.

HEALTHfirst - STAR Medicaid: 1-888-672-2277
KIDSfirst - CHIP/CHIP Perinate: 1-888-814-2352

Additional Resources

We have made our provider directory available in machine-readable format (.csv file) to follow Centers for Medicare and Medicaid Services (CMS) requirements.

 

 

Use the interactive provider search tool to find the name or location of a healthcare provider, pharmacy provider, behavioral health provider, urgent care center, or hospital. Our provider directory is a list of all types of network providers and their names, addresses, phone numbers, specialties, education, board certification, languages spoken, ages served, and more. Call Member Services if you need help locating an in-network provider or if you’d like us to send you a printed copy.

If you have been getting healthcare services at a clinic and you want to keep going there, please choose one of the doctors in the clinic as your primary care provider. The primary care provider you pick needs to be listed in our provider directory.

Some of the providers that you can also choose from to be your primary care provider are: family doctors; pediatricians (for children); OB/GYNs (woman’s doctor); general practitioners (GPs); advanced nurse practitioners (ANPs); Federally Qualified Health Clinics (FQHCs); and Rural Health Clinics (RHCs).

Everyone in your family can pick their own doctor. Once you have picked a main doctor, call Member Services to tell us the name of your main doctor.
HEALTHfirst - STAR Medicaid: 1-888-672-2277
KIDSfirst - CHIP/CHIP Perinate: 1-888-814-2352

Your primary care provider can send you to another doctor if you need a special type of care your primary care provider cannot offer. Your primary care provider will tell you if you need to see a specialist. Some specialist services require prior authorization.

Prior authorization is an approval that Parkland Community Health Plan requires for certain services and medications. Some services need approval before they are given. The provider who is treating your child should get this approval. You can ask your doctor if an approval is needed for a service or treatment, or call Member Services. A list will be provided upon request.

HEALTHfirst - STAR Medicaid: 1-888-672-2277
KIDSfirst - CHIP/CHIP Perinate: 1-888-814-2352
Monday - Friday from 8 am to 5 pm.

Your primary care provider may want you to see a specialist or another provider for care or services he or she can’t provide. You don’t need a referral from your primary care provider to get care from other doctors in our plan. This includes behavioral health services, OB/GYN care, and family planning if these are benefits in your plan. It’s a good idea to talk to your primary care provider first about other types of care you may need. He or she can tell you about other doctors in our plan and help you coordinate the care you receive.

The HEALTHfirst STAR (Medicaid) and KIDSfirst CHIP/CHIP Perinate plans do not require referrals for any services; however, there are services that may need prior authorization. Read more in your Member Handbook.

In the case of a counseling or referral service that PCHP does not cover because of moral or religious objections, PCHP must inform members that the service is not covered by PCHP. PCHP will inform members how they can obtain information from the State about how to access these services that are not covered due to moral or religious objections. At this time, PCHP does not have any services that would be denied due to moral or religious objections.  

Family planning services helps you or your child plan or control pregnancy. You do not need a referral from your child’s doctor to receive family planning services or supplies. If you are over age 21, you do not have to get permission from your parent to get family planning services or supplies. You can get family planning services from your doctor, or you can go to any family planning provider who is in the Parkland Community Health Plan provider directory. The services you can get include:

  • A yearly checkup
  • An office or clinic visit for a problem, counseling, or advice
  • Laboratory tests
  • Prescriptions and contraceptive supplies like birth control pills, diaphragms, and condoms
  • Pregnancy testing
  • Sterilization services (only if you are 21 years of age or older; Federal Sterilization Consent Form needed)

You do not need a referral from your doctor to get family planning services or supplies. You can find the location of family planning providers near you online, or you can call us for help in finding a family planning provider.

Texas Health Steps is the Medicaid healthcare program for children, teens, and young adults, birth through age 20.

Texas Health Steps gives your child:

  • Free regular medical checkups starting at birth.
  • Free dental checkups starting at 6 months of age.
  • A Case Manager who can find out what services your child needs and where to get these services.

Texas Health Steps checkups:

  • Find health problems before they get worse and are harder to treat.
  • Prevent health problems that make it hard for children to learn and grow like others their age.
  • Help your child have a healthy smile.

When to set up a checkup:

  • You will get a letter from Texas Health Steps telling you when it’s time for a checkup. Call your/your child’s doctor to set up the checkup.
  • Set up the checkup at a time that works best for your family.

How do I make my child’s appointment for a Texas Health Steps medical checkup?

You can set up a checkup with your child’s doctor. You can also set up a checkup with any Parkland Community Health Plan provider that gives Texas Health Steps checkups. Need help? You can call Parkland Community Health Plan, Monday to Friday, 8 am to 5 pm at 1‐888‐672‐2277.

Do I need a referral?

You do not need a referral to get Texas Health Steps medical or dental services.

Our health plan covers health for our members as a whole person, including help for mental health problems like depression or substance abuse. We have a Behavioral Health program for you with Carelon Behavioral Health that you can access on your own without a referral. Contact Carelon Behavioral Health at

STAR/CHIP: 1-800-945-4644

CHIP Perinate Newborn: 1-888-814-2352

Includes mental health & substance abuse; English/Spanish interpreter services available 24 hours/day, 7 days/week.

Dental checkups should start at 6 months of age. Dental checkups should be done every six months unless the dentist needs to see your child more often. Your child’s Medicaid dental plan includes services that prevent tooth decay and fix dental problems.

Parkland HEALTHfirst covers emergency dental services in a hospital or ambulatory surgical center, including, but not limited to, payment for the following:

  • Treatment of dislocated jaw
  • Treatment for traumatic damage to teeth and supporting structures
  • Removal of cysts
  • Treatment of oral abscess of tooth or gum origin

Parkland HEALTHfirst covers hospital, physician, and related medical services for the above conditions. This includes services the doctor provides and other services your child might need, like anesthesia or other drugs.

Parkland HEALTHfirst is also responsible for paying for treatment and devices for craniofacial anomalies.

Your child’s Medicaid dental plan provides all other dental services including services that help prevent tooth decay and services that fix dental problems. Call your child’s Medicaid dental plan to learn more about the dental services they offer.

Avēsis will help you get the care you need, like eye exams and glasses, while coordinating with Parkland HEALTHfirst. If you need vision services, please call Avēsis Member Services at 1-866-678-7113 

For routine eye exams, you can visit an eye care doctor without a referral from your primary care provider. You can choose an eye doctor that is close to you. Vision services are different for adults and children.

Children, teens, and young adults, birth through age 20, can get an eye exam and prescription eyeglasses once during a 12-month period. You may be able to get more services if there is a change in your child's vision. You may be able to get more services if they are requested in writing by the child’s primary care provider, teacher, or school nurse.

If you are age 21 or over, you can get an eye exam once every 24 months.

To find or change your eye doctor, call their Member Services at 1-866-678-7113 or go to their website. You can find vision information in the Member Handbook.

If you are a provider, please call 1-866-563-3591.

You can talk to a nurse when you have health questions. You can call the Nurse Line 24 hours a day, 7 days a week. Even better, this service is provided at no cost to you. The nurse can answer your questions and help you make health decisions. You can call the Nurse Line at:

Parkland HEALTHfirst STAR Medicaid
1-888-667-7890 or 214-266-8773

Parkland KIDSfirst CHIP/CHIP Perinate
1-800-357-3162 or 214-266-8766

Interpretive services are available. For members who are deaf or hard of hearing, you can call us toll-free at 1-800-735-2989. If you have an emergency, please call 9-1-1.

Prescription drugs are a covered benefit of the Medicaid and CHIP Programs. PCHP administers this benefit with the Texas Medicaid/CHIP Vendor Drug Program and our Pharmacy Benefit Manager, Navitus Health Solutions.

Toll-Free: 1-877-908-6023
BIN# 610602
Claim PCN: MCD STAR
Claim Group: PHS and CHIP / PHC
361 Integrity Drive, Madison, WI 53717
https://www.navitus.com/members

PCHP now offers telehealth services at no cost for all HEALTHfirst and KIDSfirst members age 0-21. This includes easy, convenient access to pediatricians through a partnership with telehealth provider KidzDocNow. Members can talk to a provider from 7am to 11pm, seven days a week.

Telehealth is great for:

  • Upset stomach and other digestive issues
  • Cold and flu symptoms
  • Prescription refills
  • Questions about nutrition and exercise
  • Questions about newborn health or breastfeeding
  • Mental health concerns

To use telehealth services, visit KidzDocNow.com. You can also download the free mobile app for Android or iOS devices (search for “KidzDocNow” in the Google Play or Apple App store).