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Purchased Referred Care

Emergency Vehicles


Purchased / Referred Care (PRC), formerly called Contract Health Services, assists Santo Domingo tribal members to pay for specialty medical, dental and mental health care services that are not available at the Santo Domingo Health Center, and for emergency care.

All Purchased / Referred Care must be approved in advance.

The Purchased/Referred Care is NOT AN ENTITLEMENT program nor is it an insurance program. The Santo Domingo Health Center PRC department cannot guarantee that funds will always be available.

PRC funds are intended to help pay for care when no other sources of health care payments are available or to supplement other alternate resources after they have been exhausted. The PRC program is PAYOR OF LAST RESORT, no one else or any other department can authorize payments. PRC payments are authorized through a process using federal guidelines and eligibility criteria.

Eligibility for PRC Services


The PRC program operates under federal guidelines. In order to be eligible, you must provide record of:

  • Tribal membership: You must show proof of membership in the Santo Domingo tribe.

  • Residency: Tribal members must reside in Sandoval or Santa Fe Counties.

  • If you are a full-time student you must have the PRC Student Form completed by your school.

  • Approval: Prior approval is required for all PRC funded care.

  • Obtain prior approval from the PRC Department for any non-emergency services.

  • Notify the PRC Department (505-465-3075) within 72 hours of receiving emergency services. Elderly or disabled patients have 30 days to notify the PRC Department.

PRC Requirements

Santo Domingo members who have other forms of insurance such as Medicare, Medicaid etc., please be advised other forms of insurance will be billed first. Any remaining charges for an approved service will be paid for by the PRC Program. Please present your insurance information at every visit here at the Santo Domingo Health Center (SDHC) and at all referred care appointments.

Denials and Appeals


If you should receive a Denial from our PRC department, you have the right to appeal for reconsideration. These are the steps:

  • You the patient will receive a certified denial letter in the mail from the Santo Domingo Health Center PRC Department.

  • Upon receipt of the letter, you have 30 days from the date you receive the letter to write and submit your appeal. (Instructions will be on the letter)

  • When you receive the appeal letter, we will review and discuss your case among the PRC Resource Management Committee and a decision will be made in that forum.

  • When a decision is made, the individual will be notified immediately of the result.

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