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Home » Patients & Visitors » Patient Information & Tools » Paying For Your Services » Renew Parkland Financial Assistance
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Home > Patients & Visitors > Patient Information & Tools > Paying For Your Services > Renew Parkland Financial Assistance

Renew Parkland Financial Assistance

Is your Parkland Financial Assistance (PFA) ending?



Parkland has a NEW way to review your case if your eligibility for Parkland Financial Assistance will end in the next 30 days or if it has already ended in the past 6 months. To find out if you can keep getting benefits, a face to face interview is not required.

Please follow these steps to re-apply for Parkland Financial Assistance – no appointment needed!
  1. Fill out the renewal formand asset/resource limit test. Note any changes in where you live, where you get your mail, telephone number, email address, family size. List all income (money you get).

  2. Sign and date the form.

  3. Return the completed form and copies of proof of all income received in the last 30 days. You can return the form and proof in any of the following ways:

    By Mail:
    Patient Financial Assistance Application
    Patient Financial Services
    5200 Harry Hines Blvd.
    Dallas, TX 75235

    Online:
    Go to Parkland MyChart
    (Be sure to submit application and upload proofs)


    In Person:
    Bring your renewal form and proof of income to a financial counselor. Counselors are conveniently located at Parkland clinics throughout Dallas County.

  4. If you have Medicare and are applying for Parkland Financial Assistance, please complete the asset questionnaire form.


After reviewing the completed form and proofs, we will contact you if we need more information.

To learn more about co-pays and the cost of your healthcare services while enrolled in Parkland Financial Assistance, please review the patient payment responsibility chart.

Patient Financial Assistance

214-590-8831
Monday – Friday
9 a.m. – 4 p.m.
2021 Medical District Drive
Dallas, TX 75235

Counselors are conveniently located at Parkland clinics throughout Dallas County.

Parkland provides translation services in 166 different languages.

 


 

 

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Related Documents
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Parkland Financial Assistance (PFA)
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Surprise Billing Notice
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Good Faith Estimate
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Pay my bill
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What is Parkland MyChart?
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Estimate tool
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