PARKLAND HEALTHfirst - Parkland Community Health Plan, Inc.

Members Right to Select Network Ophthalmologist/ Therapeutic Optometrist
PCHP allows members’ the right to select and have access to, without a Primary Care Provider referral, a
network ophthalmologist or therapeutic optometrist to provide eye health care services, other than surgery.
Initial Checkups upon Enrollment
PCHP will ensure that all newly enrolled members receive a checkup within two months of enrollment, if one is
due or if there is uncertainty regarding whether one is due. PCHP will make checkups a priority to all newly
enrolled members.
Texas Vaccines for Children (TVFC)
Providers with PCHP will use vaccines through and distributed by Texas Vaccines for Children Program
(TVFC). To take advantage of this free vaccine, primary care providers must be enrolled in the TVFC.
If you are currently enrolled and receiving vaccines from the TVFC, you will continue to order, receive
vaccines and report vaccine usage through the same TVFC mechanisms.
If you are not enrolled and receiving vaccines from the TVFC, please enroll immediately. To learn more on
enrollment call Provider Relations at 1-800-252-9152 or visit the TVFC website at www.immunizetexas.com.
Physician Specialist Care
The Primary Care Provider should follow the routine process as addressed in the referral section of this manual
for making a referral to a specialist.
Laboratory Tests
PCHP providers must refer laboratory tests to in-network facilities and contractors. Exceptions must be
approved by PCHP Patient Management. Please refer to your PCHP provider directory or contact Provider
Relations at 1-888-814-2352 (option 2) for information or assistance.
Newborn Examinations
PCHP must ensure that all newborn children enrolled in our plans have an initial newborn checkup before
discharge from the hospital and again within two weeks from the time of birth.
Parkland KIDSfirst and Parkland CHIP Perinate Newborn should receive screenings according to the following
schedule:
- First checkup within two months of new enrollment or sooner if due based on Periodicity Schedule
- Newborns checkup:
First checkup done at birth
Second checkup needs to be within 2 weeks
- Based on Periodicity Schedule through Age 3 years
Members over 3 years should receive at least one comprehensive health screen yearly.
Children with Chronic and Complex Conditions
PCHP meet the program rules with the Texas Department of State Health Services Standards for Care of
Children with Complex Special Health Care Needs. PCHP provide education and training programs for the
care and treatment of children with Complex Special Health Care Needs.
41