Purchased Referred Care
Purchased Referred Care (PRC) is involved in the procurement of medical services from the private healthcare sector for patients in need of care not directly available from NTHS or an IHS facility. PRC is specially funded and has specific regulatory requirements.
Referral Process
Referrals
Emergency Services
Appointments
If a patient requires care that is not available at NTHS or an IHS facility, a referral will be made to a private sector provider or service. Referrals are subject to review and approval by the PRC Review Committee. PRC is allotted a specific amount of money for each fiscal year per our funding agreement, so funds are limited.
Appointments
Emergency Services
Appointments
The PRC staff will arrange the patient's appointment with the private sector provider or service if the referral is approved by the PRC Review Committee.
Emergency Services
Emergency Services
Emergency Services
Emergency room visits to private healthcare facilities must be reported within 72 hours to the PRC staff after the beginning of emergency treatment. Cases are reviewed and prioritized in order of medical need by the PRC Review Committee. Payment for services is not guaranteed. To report an ER visit, call (918) 332-4470
Referral Process WorkfLOW
Eligibility criteria
All patients that receive PRC funding must prove eligibility
per Code of Federal Regulations (CFR) 42 Section 136.21 through 136.25
- Proof of Residency 42 CFR 136.23
- Alternate Resources 42 CFR 136.61 Subpart G
- Notification 42 CFR 136.24
Proof of Residency
Patient must provide a usable utility (water, gas, electric) bill and one other bill with patient name and physical address.
Alternate Resources OF PAYMENT
Alternate resources mean health care resources other than those of the Indian Health Service. Such resources include health care providers and institutions, and health care programs for the payment of health services including but not limited to programs under titles XVIII or XIX of the Social Security Act (i.e.,Medicare, Medicaid), state or local health care programs, and private insurance.
Northeastern Tribal Health System
7600 S Highway 69A, Miami, Oklahoma 74354, United States