Parkland Community Health Plan at a glance
| Legal name | Parkland Community Health Plan |
|---|---|
| Also known as | PCHP, Parkland HEALTHfirst |
| Category | Medicaid MCO |
| Parent organization | Parkland Health (Dallas County, TX hospital district) |
| Claims payer ID | Parkland identifies 66917 for electronic medical claims using X12 837 version 5010. This medical-claims reference does not establish the same identifier for eligibility or ERA; verify payer, product and clearinghouse. |
| Eligibility (270/271) payer ID | Stored eligibility references remain unverified for the current product and transaction. Claims identifiers do not establish 270/271 routing. |
| ERA (835) payer ID | 66917 — registry reference; verify the member product, transaction and clearinghouse. Not verified: Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier. |
| NAIC company code | Not established in this registry |
| States covered | Texas |
| Members covered | ~220k members |
| Provider resource entry point | https://providers.parklandhealthplan.com/claims-payments |
| Provider phone | Plan-specific |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Parkland Community Health Plan
This registry lists 95 days as an initial-claim reference for Parkland Community Health Plan. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
| Submission type | Window |
|---|---|
| Initial claim reference | 95 days (verify applicability) |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Parkland Community Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Parkland Community Health Plan provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Parkland Community Health Plan
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Parkland Community Health Plan electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Parkland Community Health Plan. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Parkland Community Health Plan
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Parkland Community Health Plan volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | Parkland identifies 66917 for electronic medical claims using X12 837 version 5010. This medical-claims reference does not establish the same identifier for eligibility or ERA; verify payer, product and clearinghouse. |
| 270 / 271 eligibility | Listed in registry; verify current scope | Stored eligibility references remain unverified for the current product and transaction. Claims identifiers do not establish 270/271 routing. |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | 66917 — registry reference; verify the member product, transaction and clearinghouse. Not verified: Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier. |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
portal_url
Source comparison: 2026-09-26
Current provider website serves a claims submission page and links Availity for portal access; use this public provider entry point.
Primary source for portal_urlprovider_phone
Source comparison: 2026-09-26
The current contact page explicitly labels stored 888-672-2277 as STAR Member Services, alongside a separate CHIP member line. It does not establish a universal provider-support line.
Primary source for provider_phonepayer_ids.claims
Source comparison: 2026-09-26
The claims page identifies 66917 for electronic medical claims using X12 837 5010; this is not evidence for identical eligibility or ERA identifiers.
Primary source for payer_ids.claimspayer_ids.eligibility / payer_ids.era / era_payer_id
Source comparison: 2026-09-26
Payment enrollment is handled through ECHO with separate ERA enrollment/distribution instructions; the page does not establish 66917 as an ERA or eligibility ID.
Primary source for payer_ids.eligibility / payer_ids.era / era_payer_id
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; timely_filing_days: No universal filing scalar established; verify the controlling plan, contract, jurisdiction and start event.; electronic_claims_supported / supports_279_271 / supports_278: No blanket transaction-capability or QuickIntell connectivity certification; unauthenticated resources do not establish all stored flags.; appeal_levels / prior_auth_required_codes_sample / qi_module_coverage: No new approval of appeals, code-specific authorization or product integrations in this bounded pass..
Sources used for this guide
State coverage
Parkland Community Health Plan operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for Parkland Community Health Plan
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Parkland Community Health Plan; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Parkland Community Health Plan; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Parkland Community Health Plan before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Parkland Community Health Plan
Where is the Parkland Community Health Plan provider portal?
Use https://providers.parklandhealthplan.com/claims-payments as a starting point for Parkland Community Health Plan provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Parkland Community Health Plan?
This registry lists 95 days as an initial-claim reference for Parkland Community Health Plan. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
Does Parkland Community Health Plan publish a single claims payer ID?
This registry has not established one all-product claims payer ID for Parkland Community Health Plan. Claims: Parkland identifies 66917 for electronic medical claims using X12 837 version 5010. This medical-claims reference does not establish the same identifier for eligibility or ERA; verify payer, product and clearinghouse.. Eligibility (270/271): Stored eligibility references remain unverified for the current product and transaction. Claims identifiers do not establish 270/271 routing.. ERA (835): 66917 — registry reference; verify the member product, transaction and clearinghouse. Not verified: Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier.. Do not substitute a claims ID for an unverified transaction ID. Look up the correct ID for the member's plan and transaction in your clearinghouse directory and verify against the member ID card before submission.
Does Parkland Community Health Plan accept electronic claims?
Verify Parkland Community Health Plan electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Parkland Community Health Plan denial?
This registry has not established a payer-specific appeal ladder for Parkland Community Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Parkland Community Health Plan prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
How do providers contact Parkland Community Health Plan?
This registry has not established one provider phone number for Parkland Community Health Plan. The historical 1-888-672-2277 number is STAR Member Services. Use the current provider contact route; this comparison does not establish a universal provider-support replacement. Use https://providers.parklandhealthplan.com/claims-payments as a starting point for Parkland Community Health Plan provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
Automate workflows around Parkland Community Health Plan requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Parkland Community Health Plan's current published documents before submission. CPT® is a registered trademark of the American Medical Association.