Behavioral Health
Behavioral health is defined as both acute and chronic psychiatric and substance use disorders as referenced in the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association.
Parkland Community Health Plan has contracted with, and will work in partnership with, Carelon Behavioral Health (Carelon), an Elevance Health company, to manage the delivery of mental health and substance use disorder services for the Children’s Health Insurance Program (CHIP) and the Medicaid State of Texas Access Reform (STAR) program.
Carelon defines "behavioral health" as both acute and chronic psychiatric and substance use disorders as referenced in the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association. For Medicaid eligible members, these services are administered through a State-contracted vendor (Carelon Behavioral Health).
PCPs may offer behavioral health treatment to PCHP members within the scope of their practice and may also make appropriate referrals to Behavioral Health Specialists.
Carelon will provide PCPs with assessment instruments for use in providing Behavioral Health services. Providers must use DSM-V multi-axial classifications and other assessment instruments, or outcome measures required by HHSC when assessing PCHP members for behavioral health services.
Parkland CHIP members can also self-refer to a participating Behavioral Health specialist by calling the vendor listed in Appendix A of the Provider Manual or call Member Services at 1-888-814-2352 and ask for the Health Services Department for assistance.
A PCP or other Specialist and a Behavioral Health Specialist should talk often regarding the healthcare services provided to each eligible member.
Participating Providers must comply with the Carelon Behavioral Health Clinical Practice Guidelines. Visit Carelon Behavioral Health, where you will find a dedicated Behavioral Health Provider Manual.
How to Become a Carelon Provider
Carelon Behavorial Health serves more than 40 million people across all 50 states. They welcome providers' continued commitment to participate in their network and encourage new providers to join them in their mission to help people live their lives to the fullest potential.