Purchased Referred Care

What is Purchased Referred Care?

Purchased Referred Care (PRC) is the program that pays for medical services provided outside of the Tribal Health Center, when referred by a Tribal Health Center medical provider.


Program Benefits

The following services, though not complete, are considered program benefits.

  • Physician services
  • Inpatient hospital services
  • Outpatient hospital services, including emergency room and outpatient surgery
  • Outpatient mental health services (to be managed by the Tribal mental health counselor)
  • Diagnostic laboratory services
  • Diagnostic and therapeutic radiology services
  • Home health services
  • Preventive health services
  • Optometry services (vision)
  • Physical medicine and rehabilitative services
  • Physical therapy
  • Chiropractic care
  • Prescription drugs

 

Program Policies

Click here to view the Purchased Referred Care Policies

Please call the PRC office for more information on these and other services


PRC Authorization

Eligible patients will be provided with a PRC card annually.

  • Patients present primary and other insurance cards in addition to PRC card at the time of visit.
  • After primary and secondary insurances have been billed, the PRC card authorizes a limit of $1,000 for covered services.
  • Providers must seek prior authorization if the remaining patient balance exceeds this amount.


Please call the PRC office for more information.


Urgent Medical after Hours:

If you need medical advice after hours, please call the Health Center at (360) 297-2840 and leave a message on the voice mail. The after-hours nurse on call will be paged and return your callpromptly.


Medical Emergency

If you have a life-threatening situation, immediately call 911 or proceed to the nearest emergency room.

Who is Covered?

  • Port Gamble S’Klallam Tribal members and their descendents who reside in Kitsap County.
  • Other Indians who reside on the Port Gamble S’Klallam reservation.
  • A non-Indian woman who is pregnant with an eligible Indian’s child, who resides in Kitsap County.
  • Non-Indian stepchildren who have been legally adopted by an eligible Tribal member.
  • Non-Indian foster children who are in the legal custody of an eligible Tribal member.
  • Newborn Port Gamble S’Klallam Tribal members.
  • A non-Indian member of an eligible Indian’s household in cases of acute infectious disease or public health hazard.

 

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