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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.

Eligibility criteria

  • 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-Indian women pregnant with an eligible Native American’s child for duration of pregnancy through post­partum. NOTE: The Father’s Acknowledgment form must be signed prior to receiving Purchased/Referred Care Service funds.

All patients seeking Purchased/Referred Care Service funds must:

  • Complete a Purchased/Referred Care Application
  • Provide proof of tribal affiliation. Acceptable forms of tribal affiliation include:
    *tribal identification cards, and/or
    *descendent letters.
  • Apply for alternate resources for care. Examples of some alternate resources include:
    *Medicare
    *Medical Assistance,
    *Wisconsin Well Women’s Program,
    *Disability,
    *Kinship Care,
    *Express Enrollment for Pregnant women and children

NOTE:

If patients qualify for an alternate resource, they must comply with alternate resource to receive Purchased/Referred Care Service funds.

ATTENTION:

Federal regulations require that Purchased/Referred Care Service funds are to be used only after all other alternative resources have paid.

Eligibility criteria

  • 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-Indian women pregnant with an eligible Native American’s child for duration of pregnancy through post­partum. NOTE: The Father’s Acknowledgment form must be signed prior to receiving Purchased/Referred Care Service funds.

Proof of Residency

Provide one form of proof of residency.  Documents acceptable for proof of residency are one of the following:

  • Official government documentation
  • Oneida motor vehicle documentation
  • Dept. of motor vehicle documentation
  • Traffic citations
  • Rental receipts or documentation from mortgage holder or landlord on letterhead.
  • Direct deposit receipts or payroll stubs
  • Current active bank statements and e-statements with dates included
  • Child support (checks, letters or statements)
  • Credit card statements
  • Acceptance letters (college/grants)
  • Dated transcripts with address listed
  • Utility bills (heat, water, sewer and garbage disposal)
  • Cable, satellite bills
  • Telephone, cell phone bills

NOTE:  your name, address, and current date must be visible and it must be a current document from within the past 60 days.

General E-mail Address

Purchased/Referred Care

[email protected]

You are now able to scan and email us the following documents:

  • Bills for Purchased/Referred Care
  • Proof of Residency
  • Purchased/Referred Care Application

Questions? Please call Purchased/Referred Care at 920-869-2711

 

Additional/Contact Info