Policies

To eliminate confusion listed below are forms that pertain to members of the Paiute Indian Tribe of Utah. Those who are eligible to receive Purchased Referred Care. (PRC)

pdfPurchased Referred Care (PRC) Application for Alternate Resources
pdfPurchased Referred Care (PRC) CPAP BIPAP Policy and Procedure
pdfPurchased Referred Care (PRC) Per Diem & Mileage Reimbursement Policy 
pdfPurchased Referred Care (PRC) Vision Care Policy
pdfPurchased Referred Care (PRC) Referral Policy and Procedure
pdfPurchased Referred Care (PRC) Covered Dental Services Policy
pdfPurchased Referred Care (PRC) Diabetic Therapeutic Shoes and Inserts Policy 
pdfPurchased Referred Care (PRC) Emergency Dental Services Policy
pdfPurchased Referred Care (PRC) Transportation Policy
pdfPurchased Referred Care (PRC) Hearing Aid Policy 
pdfPurchased Referred Care (PRC) Claims Payment Policy 
pdfPurchased Referred Care (PRC) Prior Authorization Policy 

General information for Tribal and Non-Tribal members:

 
  

Behavorial Health Forms