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Formerly known as Contract Health Services and/or Purchased and Referred Care (PRC) On December 1, 2016, the Confederated Salish and Kootenai Tribes assumed management of the Indian Health Service Purchased and Referred Care (PRC), also known as Contract Health Services. The Tribes
administer the program through Tribal Health, renaming the program Tribal Health Paid Care (THPC). THPC has been assigned the following tasks— The first is to determine a Tribal Health recipient's eligibility for THPC and to ensure that all the recipient’s health care coverage options have been exhausted. Second, THPC staff receive referrals from providers for health care services and review for possible payment. Finally, staff works with eligible recipients to navigate the care they may need to the fullest extent possible.
Tribal Health uses the THPC funds in conjunction with other health care coverage or insurance, such as Medicaid; Medicare; Veterans Health Administration; Affordable Care Act; Healthy Montana Kids; employer insurance; private insurance; and self-pay. THPC by law, is a payer of last resort (under regulations of the Public Law 93-638 Indian Self-Determination and Education Assistance Act), meaning that the program can only pay when all options for other health care coverage or insurance have been exhausted.
Each Tribal Health recipient requesting THPC will be asked to complete the necessary application to determine eligibility for payment. Tribal Health’s goal is to “Get to Yes” for recipients seeking health care services. Through recipient cooperation and utilization of all available resources, Tribal Health works to get recipients the care they need.
Formerly known as Contract Health Services Purchased and Referred Care (PRC)
In addition to a completed application, recipients will be asked to provide proof of residency. Acceptable forms for proof of residency must show a current physical address as follows:
The following examples are some of the potential services funded by THPC, including but not limited to:
By federal law, THPC is a payer of last resort. This obligates Tribal Health and eligible recipients to use any and all alternative health care coverage before THPC is available to cover costs.
FOR MORE INFORMATION CONTACT TRIBAL HEALTH PAID CARE (THPC):
Susan Johnson, THPC Business Office - (406) 745-3525 ext. 5029 email@example.com
Clarice Cooper, THPC Medical Review - (406) 745-3525 ext. 5013 firstname.lastname@example.org