Purchased Referred Care
Purchased/Referred Care (previously known as Contract Health) Service is a financial resource to assist in payment for healthcare services that cannot be directly provided at the Oneida health care facilities.
The first step for utilizing purchased/referred care funds is a referral for services must be determined by the patient’s Oneida Community Health Center and/or Oneida Behavioral Health primary care provider. Then a Purchased/Referred Care Representative will determine eligibility based upon federal regulations.
All patients seeking Purchased/Referred Care Service funds must:
- Read the Purchased Referred Care Packet and complete application:
- Fillable Form (to be completed on computer)
- Non-Fillable Form (to be printed out and completed)
- Provide proof of residency
- Provide proof of tribal affiliation. Acceptable forms of tribal affiliation include:
*tribal identification cards, and/or
- Patients with no insurance must apply for alternate resources for care. Examples of some alternate resources include:
*Wisconsin Well Women’s Program,
*Express Enrollment for Pregnant women and children
If patients qualify for an alternate resource, they must comply with alternate resource to receive Purchased/Referred Care Service funds.
Federal regulations require that Purchased/Referred Care Service funds are to be used only after all other alternative resources have paid.
- Oneida tribal member or descendent residing within Brown or Outagamie County
- Member of another federally recognized tribe residing in Brown or Outagamie County with a social or economic tie to the Oneida Nation
- Member or descendent of another federally recognized tribe residing within the Oneida Reservation boundaries
- Students who meet eligibility guidelines at their permanent residence prior to leaving for school. Student must supply purchased/referred care service application with a copy of full-time student status each semester
- Eligible patient that leaves the community, may continue to be eligible for 180 days
- Non-Native women pregnant with an eligible Native American’s child for duration of pregnancy through postpartum, as long as prenatal care is done through OCHC or referred out by Oneida provider. NOTE: The Father’s Acknowledgment form must be signed prior to receiving Purchased/Referred Care Service funds for unmarried parents.
Proof of Residency
Provide one form of proof of residency. Documents acceptable for proof of residency are one of the following:
- Official government documentation
- Documentation from mortgage holder or landlord on letterhead.
- Direct deposit or payroll stubs
- Current active bank statements and e-statements with dates included
- Acceptance letters (college/grants) and dated transcripts
- Utility bills (heat, water, sewer and garbage disposal)
- Cable, satellite, telephone, cell phone bills
NOTE: your name and address must be visible and it must be a current document from within the past 60 days.
Examples of UNACCEPTABLE proof of residency forms: Personal mail, Envelopes, Collection statements, Medical bills, Bulk/junk mail, Vehicle registration renewals.
General E-mail Address
You are now able to scan and email us the following documents:
- Bills for Purchased/Referred Care
- Proof of Residency
- Purchased/Referred Care Application
- Proof of Income
Please NOTE: It is not acceptable to send cellphone pictures of documents required.
Questions? Please call Purchased/Referred Care at 920-869-2711