Insurance

Getting coverage

Business Office

Donald A. LaPointe Health & Education Center
102 Superior Avenue
Baraga, MI 49908
906.353-8700 and 906.353.4521 – Reception
906.353-4507- Patient Benefits

Services

The Business Office handles all the billing and payments for services rendered at the Donald A. LaPointe Health & Education Center.

In order to bill the patient and insurance companies correctly we ask that all patients register on each visit to verify their address, insurance information, and to make sure all necessary forms are filled out and signed.

Please check in with the Reception staff who are located on 1st & 2nd floor before you proceed with your appointment.

Purchase Referred Care (PRC)

Purchased Referred Care (PRC) is a federally funded program by Indian Health Services to provide financial support to pay for Health Services that cannot be provided at the KBIC DHHS.
In order to be eligible for Purchase Referred Care you must:

1. Be a tribal member of a Federally Recognized tribe

2. Reside within the Purchased Referred Care Service Delivery Area (PRCSDA): Baraga, Houghton, Ontonagon County

3. Apply for Medicaid/Medicare if you do not have insurance, or the Health Insurance Marketplace. (Alternate Resource). The term Alternate Resource also pertains to the KBIC Medical/Dental Clinic. The KBIC PRC office will not pay for services that could be cared for at the KBIC MEDICAL/DENTAL CLINIC during normal business hours. Only emergency services at local hospitals will be covered. (An emergency room visit for “common cold” or for running out of medications is not a life threatening condition)

4. Have a Medical Condition that is a diagnosed as a threat to life, limb or sense (Priority 1): This is done by getting a referral from KBIC Physician. A referral alone does not guarantee payment for medical services. If you receive orders from your referral physician, make a follow-up appointment with the Tribal physician for another referral if you need it.

5. Obtain prior authorization for the referral with a VOUCHER from the PRC OFFICE

6. If you received treatment from the emergency room for a life-threatening condition, you must notify the PRC Office (353-4537) within 72 hours. (For elderly, disabled patients, notification must be given within 30 days of receiving emergency services)
Failure to follow these policies will result in a denial of payment. Always contact the PRC Office for any medical care that you need before getting the service done. Funds from Indian Health Service for Purchased Referred Care Services are limited; the KBIC PRC Office cannot approve payment for any services once funding for PRC has been depleted. It is highly encouraged that if you are able to take insurance through your employer, you do so if funding for Health Services is depleted.

ARE YOU PRC ELIGIBLE?

View PRC Easy Summarized Guide
PRC Module Eligibility
PRC Module Transcript

Tribal Exemption Form (link)