Formerly known as Contract Health Services, Choctaw Referred Care is a special service that the Choctaw Nation Health Services Authority provides to patients. Although the Choctaw Nation Health Services provides a vast array of services, there are still many that are not provided at our facilities. Some of the care may require that you be treated at a non- Indian hospital, clinic and/or physician’s office.
This care, when authorized, is paid through the Choctaw Referred Care (CRC) program. These services are one of the most important elements of the health care delivery system for Native Americans.
All referrals are processed through the CRC services program to determine eligibility. Medical priorities are also established in accordance with federal regulations and community medical standards. In general, CRC services try to pay for the most life-threatening cases. Due to limited funding, there are times when CRC cannot pay for all services, although every effort is made to do so.
Choctaw Referred Care Eligibility Criteria:
1. Must have a CDIB (Certificate Degree of Indian Blood) and be a member of a federally recognized tribe.
2. Must be a permanent resident within the Choctaw Nation Health Service area (Atoka, Bryan, Choctaw, Haskell, Latimer, Leflore, McCurtain, Pittsburg, or Pushmataha county).
3. You must use all other resources to pay for your referred care such as Medicare, Medicaid, VA, Workers Compensation, Title XIX or SoonerCare, automobile insurance, homeowners insurance, and/or group health insurance. We are the payer of last resort.
4. All persons asking for CRC to pay medical expenses are screened for Medicaid (also known as Title XIX or SoonerCare). If we determine you are likely eligible, then we require you apply for Medicaid. This can be done online at www.mysoonercare.org
5. We require that you provide us proof that you have lived in the Choctaw Nation CRC area for 180 days prior to your application for CRC funds.
6. Must have an approved referral through CRC. The referrals must be initiated by either a Choctaw Nation physician or another Indian Health Services physician.
7. When emergency care is required at another facility and you are not able to get to an IHS/Tribal facility, the patient or someone acting on his/her behalf must pre-certify with the Choctaw Nation Referred Care within 72 hours after the beginning of treatment. Authorization for payment will be determined on the basis of medical priorities and the availability of funds. Calling in does not guarantee service will be paid by CRC. Minor injuries or illnesses treated in a non- Indian hospital emergency room seldom meet our guidelines for medical priority.