Purchased / Referred Care

Overview

Purchased/Referred Care (PRC)

Purchased/Referred Care (PRC) is a financial assistance program that helps eligible beneficiaries pay for medically necessary healthcare services that are not available through an Indian Health Service (IHS), Tribal, or Urban (ITU) healthcare facility, such as Ponca Health Services.

PRC is the payer of last resort, which means all other available health coverage and payment resources (such as Medicare, Medicaid, private insurance, VA, Worker’s Compensation) must be billed before PRC can be considered for payment.

PRC explanation video
Overview

How PRC Works

For most non-emergency services:

  1. A Ponca Health Services provider determines that care is needed outside the facility.
  2. The provider submits a referral to the PRC program on the patient’s behalf.
  3. The PRC Committee reviews the referral to determine medical priority, eligibility, and available funding.
Emergency Care If you receive emergency medical care, the PRC program must be notified within 72 hours of receiving services. Notification may be made by:
  • You (the patient)
  • A family member or someone acting on your behalf
  • Your healthcare provider
  • The hospital
If you are 65 years of age or older or have a documented disability, you have 30 days to provide notification.

Important Notice

72-hour emergency notification

Notification does not guarantee authorization or payment. PRC eligibility, medical priority, available funding, and payer-of-last-resort requirements must all be met. If PRC is not notified within the required timeframe, your medical bills may not be considered for payment through the PRC program.

Contact PRC
Learn More

PRC Resources

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PRC Fact Sheet PDF
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PRC Handbook PDF
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PRC Overview PDF
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PRC Process Handout PDF
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Medical Billing Concern Flyer PDF
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PRC Staff

Contact Information