Purchased Referred Care, or PRC, is a program funded through Indian Health Services (I.H.S) that helps eligible individuals pay for health and dental costs outside of the St. Croix Tribal Health Clinic. The St. Croix Tribal PRC program is located in the St. Croix Tribal Health Clinic, and is managed by Linda Taylor, with Kayla Anderson assisting.
PRC is not an entitlement program and a referral from the St. Croix Tribal Health Clinic does not imply that the appointment will be paid. PRC must be requested if help with outside health/medical costs are needed or wanted. If PRC is requested, then the individual must meet the following guidelines:
1. Individual must be a St. Croix Tribal Member or St. Croix Tribal Descendant to the second degree. Tribal Verification is required to be on file.
2. Individual must live in the St. Croix Tribal Service area, which is the counties of Burnett, Barron, Washburn, Polk and Pine (St Croix Tribal Members only in Pine). Proof of residency may be required.
3. Individual must have a primary insurance, as PRC is a payor of last resort. If there is no insurance, individual must meet with Kayla Anderson, the Benefits Specialist/PRC Assistant to apply for all alternate resources before PRC will approve any request.
4. Individual must utilize the St. Croix Tribal Health Clinic at least once per year to keep information updated.
5. Notification is required for ALL appointments. Prior notification is required for upcoming appointments. Emergency room/hospitalizations must be called in to the PRC Office no later than 72 hours of discharge. Elders of Medicare age or disabled individuals have 30 days to call in emergency room visits or hospitalizations.
6. Medical/Dental priority of care. Reason for visit is required, as I.H.S. has a list of priorities for the different types of care that are covered under PRC. Not all procedures are covered. If PRC runs low on funding for the year, the program will only pay for procedures that are considered high priorities per I.H.S. Guidelines.
The PRC Program works on a purchase order system. When notification is given to our office of an upcoming appointment, emergency room visit, or hospitalization, a purchase order is sent to the facility on the individuals behalf. Once that purchase order is sent, it obligates our program to pay as the secondary insurance. Because the PRC program works like a secondary insurance, health claims are required from the facility to pay. PRC does not pay actual bills that are received from a medical facility, so if you do get a bill from a medical facility, please bring that bill into the PRC Office right away so we can get it sorted out. Not all facilities that we send purchase orders to work well with us.
If you have any questions on how this program works please give us a call or go online to www.IHS.gov and look up Purchased Referred Care for general information. This is a great resource to utilize if you cannot pay those outside medical/dental costs.
The St. Croix Tribal Clinic’s phone number is #715-349-8554. Linda’s extension is 5162 and Kayla’s extension is 5256.