Public Care
The Bearskin Health Clinic is a staffed, on-site clinic that is receiving and seeing patients from the public on a daily basis. Family practitioners and in-house lab work is available to the public and does not require enrolled membership in Wyandotte Nation or the Eastern Shawnee Tribe of Oklahoma to take advantage of these services. We are always welcoming new patients and accept with confidence the responsibility of providing you with the very best in diagnosis, prescription, and treatment.
Purchased/Referred Care
Purchased/Referred Care (PRC) is a federally-funded program by the Department of Health and Human Services to assist eligible patients financially with specialized care that is not directly available from Bearskin Healthcare. Because the PRC program is not fully funded, the PRC program must rely on specific regulations relating to eligibility, notification, residency, and a medical priority rating system.
PRC funds are intended to pay for care where no other sources of health care payments are available, or to supplement other alternate resources after they have been exhausted. The use of alternate resources allows PRC to maximize funds so that a wider range of health care may be provided to as many tribal members as possible. Purchased/Referred Care is a supplement to other third-party reimbursement services. When services are not available at Bearskin Healthcare, contracted facilities or an IHS facility, the physician will initiate a referral to a contract specialty provider. After the referral is initiated by the physician, the patient must meet with a member of the PRC staff to approve scheduling of the appointment.
Payments for healthcare can only be authorized by a PRC ordering official. No one else can authorize payments. PRC payments are authorized through a process using federal guidelines and eligibility criteria. Additionally, the program provides quality, cost-effective/efficient services that preserve the rights of the clients.
Eligibility for services are limited to those individuals who are enrolled members of the Wyandotte Nation or Eastern Shawnee Tribe of Oklahoma; reside within one of the twelve counties (Ottawa, Craig, Mayes, Wagoner, Delaware, Rogers, Okmulgee, Nowata, Tulsa, Creek, Okfuskee, Washington) which comprise the Service Delivery Area (CHSDA).
Bearskin Healthcare contracted facilities include: Hillcrest Medical Center in Tulsa, Integris Baptist Regional Health Center in Grove and Miami, Mercy Hospital in Joplin, Missouri, Craig General Hospital in Vinita, Freeman Health System in Joplin, Missouri, and Claremore IHS Hospital. The PRC program also contracts with specialty care physicians, hospitals, diagnostic groups and other health care providers to treat our patients at prearranged fees.
PRC is designated as a payer of last resort, meaning that all other available alternate resources must first be used before PRC payment. An Indian Health/Tribal/Urban (I/T/U) facility is deemed an alternate resource when available and accessible.
Important Notice: All services REQUIRE prior authorization before obtaining services or a 72-hour notification following self-referred care (emergent care).
Specialty Care
Specialty Care is referred services by Bearskin Health Clinic for tribal members only. The requirements for Specialty Care eligibility are as follows:
- Must be eligible for direct patient care services provided by Bearskin Health Clinic contracted facilities and/or an IHS facility. An individual is eligible if they are of Indian descent and a member of the Wyandotte Nation or Eastern Shawnee Tribe. Patient must also have an established medical health record at Bearskin Health Clinic.
- Non-Indians may be eligible in these situations: a non-Indian woman who is pregnant with an eligible Indian’s child through pregnancy and postpartum; or a non-Indian member of an eligible Indian’s household who resides within the CHS service area is eligible for CHS if the Medical Officer in charge determines that services are necessary to control a public health hazard or an acute infectious disease.
- Patient must reside within the Bearskin Health Clinic 12 county CHS service area within Oklahoma.
Out-Of-State residents are not eligible for CHS funds. Each patient must meet the federal criteria listed, as well as produce documentation on proof of residency. Documents required to be presented for service include:
- Social Security Card
- Oklahoma Driver’s License or Oklahoma State issued Identification Card
- Tribal Membership Card
- Residency Requirements (3 needed):
- Utility Bill in patient’s name with physical address – lease agreement, gas, electric.
For individuals that do not have a utility bill or lease in their name and reside with other individuals:
- Previous years taxes (front page verifying state filed)
- Land Tax statement
- Recent School Records
- Notarized affidavit verifying residence
- Mortgage payment
The services listed below are designated according to their availability to the public or members-only. We’re looking forward to treating you and helping you get back on the road to recovery!