Claims Submission
Providers may submit medical claims to PCHP using the following methods:
- Electronic submission (EDI – Preferred)
- TexMedConnect
- Paper (hard copy)
Electronic (EDI) Claims Submission
Providers may submit medical claims electronically to Parkland Community Health Plan using EDI X12 837 5010 transactions.
The Parkland Community Health Plan Payer ID for electronic claims is Payer ID # 66917.
TriZetto Provider Solutions: Our Preferred Electronic Data Interchange (EDI) Source
Parkland and Cognizant Healthcare Services, LLC (a subsidiary of Cognizant Technology Solutions) are partners. Part of that business venture includes encouraging our providers to submit electronic claims through Cognizant’s TriZetto Provider Solutions (TPS).
TPS is more than just a clearinghouse. It provides exceptional service by combining enhanced provider solutions with superior client support. TPS is Parkland’s preferred EDI connection.
If you would like to connect directly to TPS at no cost, please complete this form.
If you already use a clearinghouse, such as Availity, Office Ally, Emdeon, Claim Logic, etc., your claims will be sent to Parkland. There will be no changes, and you do not need to complete the form.
For more information, please email TTPSSupport@cognizant.com
TexMedConnect
Claims may be submitted electronically to TMHP through TexMedConnect on the TMHP website at tmhp.com
Paper Claim Submission
Providers may submit medical claims on CMS approved paper forms (CMS-1500 or CMS-1450) to Parkland Community Health Plan. Providers must submit paper claims in the appropriate format and must be legible.
Paper Claim forms mailing address:
Parkland Community Health Plan
Attn: Claims
P.O. Box 560327
Dallas, TX 75356