Purchased Referred Care (PRC)

What is Purchased Referred Care (PRC)?

A program funded under Indian Health Service, Department of Health and Human Services that covers contract quality health/medical care. Qualified individuals are provided assistance with health care, thereof ensuring financial coverage for health care costs.

Alternative Resource

Alternative Resource

If you have an "alternative resource", such as Medicare, Medicaid, Blue Cross/Blue Shield, or other private insurance, and Workers Compensation, you must use these plans as a source of payment first.

Service provided by Purchased Referred Care (PRC)

PRC can provide payment for the following service

  • Inpatient hospital stay and physician charges
  • Outpatient hospital services, outpatient physician fees and medical specialist fees
  • Dental
  • Medical and surgical supplies
  • Pharmacy
  • Optometry
  • Consultation specialists when referred by a primary-care physician
  • Patient travel costs to receive health care services

Medical Emergency

If you should need emergency treatment, you, or someone acting for you MUST contact CHS within 72 hours (3 days) from the time treatment began. If proper notification is not done, payment of services may be denied.

Some examples of emergencies are:

  • Trouble breathing
  • Chest pains
  • Bad burns
  • Poisoning
  • Broken Bones
  • High fever in infants or children
  • Life threatening accidents/injuries

Non-emergency Medical Appointments

  • Contact the PRC department prior to scheduling an appointment with a health care provider
  • Authorization for services will be approved/disapproved according to medical priority
  • If you receive authorization, you must make your own medical appointments. If needed, a PRC staff person is available to assist you with making appointments.
  • You will need to call PRC with your confirmed appointment date/time immediately after making the appointment.