What is Purchased Referred Care?

Purchased Referred Care (PRC) is a benefit to Alaska Native and American Indian people that provides funding for referred medical services not available at Miccosukee Health Center (MHC).

Who is eligible?

PRC has various requirements for qualification. To be eligible for PRC, you must:

• Be eligible for Direct Care.
• Live within the Contract Health Service Delivery Area (CHSDA): Miami-Dade, Broward, Collier, and Monroe.
• All patients are screened for Medicaid, Medicare, or private health insurance FIRST before utilizing PRC.

What is the referral process?

Visit your primary care provider, and if necessary, they will initiate a referral.

• A (MHC) physician must initiate all (NON-MHC) facility referrals.
• The Managed Care Committee, which consists of doctors, nurses, and PRC staff, reviews and approves the patient for referral.

What is the process for emergency medical care outside of Miccosukee Health Center?*

• In an emergency, seek medical attention first.
• It is the responsibility of the patient or the patient’s family to notify (MHC) PRC within 72 hours of treatment. Anyone acting on behalf of the patient can make the call.
• Elders must call in emergencies within 30 days of receiving care.

* Please note that referrals may be denied if it is determined that the requested services could have been provided through (MHC).

Why hasn’t my bill been covered?

PRC strives to pay every bill in a timely manner. Some obstacles to prompt payment are as follows:

• The patient does not have a referral from a Miccosukee Health Center (MHC) provider prior to receiving services.
• The patient has not complied with alternate resources.
• The patient’s chart is not complete.
• An outside provider has not sent the claim to the (MHC) billing address.
• The patient does not bring statements from his or her outside provider to PRC.