To Be eligible for Purchased & Referred Care, Patients should meet the following requirements:

• Have an active chart at LTHC.
• Should have insurance or apply for health insurance. (Our Tribal Assisters can help!)
• Must be an enrolled US Tribal member and show proof of enrollment.
• Must live within our delivery area, which is Whatcom County for Lummi members and the boundaries of Lummi Nation for members of other enrolled tribes.
• Eligibility also extends to foster children who are placed outside of Lummi’s PRC delivery area, tribal members that leave the PRC delivery area for temporary work or for travel, or Full-time students attending an accredited college.

Remember, PRC is always the payor of last resort.

If seeking a referral, you should be referred by a LTHC provider, or coordinate any outside referrals/ doctors’ orders with the referral specialist.

Any denial of PRC funds must be appealed in writing within 30 days and a letter must be dropped off at the drop box in front of the clinic.

When referred to a specialty office, if they send you for other services, labs, or x-rays, make sure to request a copy of the order or have them fax it back to referrals. Call any PRC staff if you have any questions.

Refer to our “Access to Healthcare Services & Purchased & Referred Care” Graph below for a step by step guide from setting up a patient chart, to processing a PRC bill.

If you have any questions, please feel free to contact one of our PRC staff members.