Find a Provider

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

Your primary care provider (PCP) may send you to a specialist if you need care your PCP cannot offer. Some specialist visits or treatments require prior authorization.

Prior authorization means Parkland Community Health Plan must approve the service before you receive it. Your provider will submit the request if it’s required. You can always ask your doctor or call Member Services if you want to know whether a service needs approval. A list is available upon request.

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 STAR Medicaid and 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.

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:

STAR
1-888-667-7890 or 214-266-8773

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 7-1-1. If you have an emergency, please call 9-1-1.

Family planning services help you plan or control pregnancy. You do not need a referral from your primary care provider to receive family planning services or supplies. If you are under 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 primary care provider, or you can go to any family planning provider who is in our 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 primary care provider to get family planning services or supplies. You can find the location of family planning providers near you online, or you can call us at 1-888-672-2277 for help in finding a family planning provider.