Purchase Referred Care (PRC)

(previously called Contract Health Service or CHS)

Purchased Referred Care (PRC) is a federally-funded program by Indian Health Services to provide financial support for health services that cannot be provided at the Gun Lake Tribal Health Center (GLTHC).

In order to be eligible for PRC you must:

1. Be a Citizen of the Gun Lake Tribe.
2. Reside within the PRC 5-county Service Delivery Area (PRCSDA): Allegan, Barry, Kalamazoo, Kent, and Ottawa.
3. Apply for Medicaid/Medicare if you do not have insurance, or the Health Insurance Marketplace. (Alternate Insurance Resource). The GLTHC PRC office will not pay for outside services that could be cared for at the GLTHC during normal business hours. Only true emergency services at local hospitals will be covered. (An emergency room visit for “common cold” or for running out of medications is not a life-threatening condition)
4. Have a Medical Condition that is a diagnosed as a threat to life, limb or sense (Priority 1): This is done by getting a referral from GLTHC Physician. A referral alone does not guarantee payment for medical services. If you receive orders from your referral provider, make a follow-up appointment with the Tribal physician for another referral if you need it.
5. Obtain prior-authorization for the referral from the PRC staff.
6. If you received treatment from the emergency room for a life-threatening condition, you must notify PRC staff (269.397.1760) within 72 hours.

Failure to follow these policies will result in a denial of payment. Always contact PRC staff for any medical care that you need before getting the service done. Funds from Indian Health Service for PRC services are limited; the GLTHC PRC staff cannot approve payment for any services once funding for PRC is gone for the fiscal year. We highly encouraged you to take insurance through your employer if you are able.

LEARN MORE ABOUT PRC

ARE YOU PRC ELIGIBLE? Link

PRC Enrollment Forms Link

PRC Office Staff: