Purchase Referred Care
Offered at:
Quick links
Location information
Opening Hours
Monday-Friday
7:30am - 11:30pm
Saturday, Sunday
Closed
NOTE: Closed on Federal Holidays or mandatory hospital trainings.
Phone: (928) 729-8181 /8195
Fax: (928) 729-8198
Mailing Address: PO Box649 Ft. Defiance, AZ 86504
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Location information
Opening Hours
Monday-Friday
8am - 6pm
Saturday, Sunday
Closed
NOTE: Closed on Federal Holidays or mandatory hospital trainings.
Phone: (928) 688-5600
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Approach to Care
What is Purchased Referred Care (PRC)?
Formally known as "Contract Health Services", Purchased Referred Care (PRC) is a benefit to the American Indians and Alaskan Natives (who reside on tribal lands) that provides funding for referred medical services not available at an IHS or tribal facility. The dedicated PRC team is here to support patients in accessing essential healthcare, preventing medical billing issues, and providing guidance on next steps if Purchase Referred Care cannot cover their medical expenses. Your health and well-being are our top priorities!
PRC is a “Payer of Last Resort”
PRC will review eligibility criteria and assist patient with application for alternate resources if patient is eligible.
Alternate Resources
- MedicareA/B
- Arizona or New Mexico Medicaid
- Private Insurance
- IHS or Tribal health facilities
If patient is not eligible for alternate resources then PRC will approve referral and submit payment.
Need Assistance?
If you need assistance with interpretation, understanding of information, or application to alternate resources, please contact PRC:
Tsehootsooi Medical Center:
(928) 729-8437
(928) 729-8098
(928) 729-8096
(928) 729-8336
Nahata'Dzill Health Center:
(928) 688-5654
Purchase Referred Care
Areas of Care
Categories will appear in production
NDHC PRC Referral Care Specialist:
Evelyn Bennallie: 928-688-5628
Lisa Higgins: 928-688-5602
NDHC PRC Referral Care Specialist:
Non-emergency Medical Transport
Non-emergency medical transport (NEMT), is based upon upon eligibility and availability.
Dispatch Phone: 928-729-8151
Non-emergency Medical Transport
PRC Team
PRC Clerk:
Deven Wauneka 928-729-8195
Tawni Billie 928-729-8195
Kaila Nez 928-729-8195
Sandra Yazzie 928-729-8297
PRC Case Manager:
Madeline Sampson 928-729-8179
PRC Manager:
Elouise Lee 928-729-8192
PRC Team
TMC PRC Referral Care Specialist:
Alberta Wilson: 928-729-8193
Mary Ellen Herrera: 928-729-3798
Bertha Harrison: 928-729-8191
Rachelle Johnson: 928-729-8180
Karen Hosteen: 928-729-8802
FrancesJordan: 928-729-8197
Cindy Nez: 928-729-8188
Margaret Bob: 928-729-8189
TMC PRC Referral Care Specialist:
Purchase Referred Care
Policies
PRC approval requires 5 eligibility criteria:
- Indian Descent – Must be a member of a federally recognized Tribe with a census number. This includes a non-Indian woman pregnant with an eligible child.
- MedicalPriority – Services must be necessary within the Navajo Area Medical/DentalPriorities. Funds are available to pay for emergency medical conditions as defined within current priorities.
- Residency– Must live within the current Tribal Contract Health Service Delivery Area(CHSDA). Residence status continues for 180 days calendar after leaving (CHSDA).
- AlternateResource – Patient must apply for all accessible and alternate resources such as Medicare/NM Medicaid/AZ Medicaid ALTCS/Workman’s compensation. IndianHealth Service is the payer of last resort.
- Notification– Patient or someone on their behalf, must notify PRC within 72 hours after an ER treatment or hospitalization.
- Name/Date of Birth
- Facility of encounter
- Phone number
- The reason for visit or diagnosis
- Date of encounter
*Notification does not guarantee payment
Purchase Referred Care
Team
Related Resources
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Explore all resources
Can my None-Emergency Medical Transport driver pickup my referral?
Do I need a referral for every appointment by a specialist off the reservation?
If I get referred to a specialist at a different health facility off the reservation, am I responsible for my bill?
What is the U. S. Treaty obligation for American Indian Health?
Why are Indian descendants not eligible for Purchase Referred Care (Contract Health) off the reservation?
Will PRC pay for lodging and meals while traveling for specialized care?