SCIT Tribal Members, Families, and Community,

At SCIT Health & Human Services (SHHS), we want our Community to better understand an important healthcare resource available through Nimkee Memorial Wellness Center — Purchased/Referred Care (PRC).

What is PRC?

PRC stands for Purchased/Referred Care, a federally supported program through the Indian Health Service (IHS) that may help eligible American Indian and Alaska Native patients obtain medically necessary healthcare services outside Nimkee, such as specialty consultations, hospital services, emergency care, and certain dental procedures.

Who May Be Eligible?

Eligibility is determined individually based on applicable federal and Tribal program requirements, including:

• Tribal Eligibility: Membership in a federally recognized Tribe or another qualifying eligibility category.
• Residency: Generally, residence within Nimkee's designated service area: Isabella, Midland, Clare, Arenac, and Missaukee counties, subject to applicable exceptions.
• Medical Necessity: Services must meet established medical priorities and funding requirements.
• Other Insurance: Available insurance and healthcare resources must be utilized first.

Important: PRC Is the "Payer of Last Resort."

This means Medicare, Medicaid, private insurance, and other available resources must generally be considered before PRC funding. PRC is not an automatic entitlement, and a medical referral does not guarantee payment.

What Should You Do?

1. Non-Emergency Care: Contact Nimkee PRC and obtain required authorization before receiving outside medical services.
2. Emergency Care: Seek immediate emergency treatment when needed. Notify PRC within 72 hours after treatment begins or hospital admission.
3. Elders and Individuals with Disabilities: Federal provisions allow qualifying patients age 65 or older and individuals meeting the applicable disability criteria up to 30 days to provide emergency notification.
4. Documentation: Keep your Tribal enrollment information, residency verification, insurance cards, referrals, and medical bills available for PRC review.

Our Wonderful Nimkee PRC Team

We are fortunate to have a dedicated PRC Team led by Ms. Shelly Reihl, under the supervision of Ms. Val Raphael, Business Office Manager (BOM). Their commitment to assisting our Tribal Members and families in navigating healthcare referrals, eligibility, and payment coordination is sincerely appreciated.

Questions or Need Assistance?

Nimkee Memorial Wellness Center
2591 S. Leaton Road, Mount Pleasant, MI 48858
Phone: (989) 775-4600 — Ask for the PRC Department.

For additional information, please visit the https://www.ihs.gov/forpatients/prc/

Our goal is simple: Help our Tribal Community understand available healthcare resources, navigate the process, and access appropriate care.

Miigwech to our PRC Team for your continued dedication to our Community!