Contract Health Services is healthcare purchased by the Kickapoo Contract Health Service (CHS) program from non-Indian Health Service (IHS) providers and facilities when direct services of care are not available.

Due to the limitation of CHS resources, funds are managed following established medical priorities.

CHS resources are for referred services and emergency services.

Emergency Room Policies

  1. Emergencies that are determined to be non-emergent (not life or limb threatening will not be funded by CHS). These services can be obtained at the Kickapoo Tribal Health Center, Monday, thru Friday, or at an I.H.S. hospital located in ADA, LAWTON, CLAREMORE, or OKEMAH (24 hours a day).
  2. Patients with life or limb threatening emergencies are advised to go to the nearest emergency treatment center.
24 Hour IHS Facility Address Phone Numbers
Chickasaw Nation Medical Center

 

1921 Stonecipher Blvd. Ada, OK 74820 Main Line: (580)436-3980 Alt:(800)851-9136

Fax: (580)421- 4552

Lawton Indian Hospital Services 1515N. Lawrie    Lawton, OK 73507 (580)354-5000 or (580)353-0350 Alt.Line (888)275-4886
Patient Feedback: (580)354-5317
Creek Nation Indian Hospital Svc. 309 N. 14th Street Okemah, OK 74859 Phone: (918)623-1424  Alt. Line: (800)219-9458
Claremore Indian Hospital Services 101 S. Moore Ave. Claremore OK 74017 Phone: (918)342-6200
Alt Line (888)275-4886

How does CHS work?

A referral request is reviewed weekly and ranked according to relative medical priority. Applications are approved for CHS payment to the extent of available resources for the review period.

Eligibility and Requirements

Patients must meet eligibility, notification, pre-authorization, and alternative resource requirements of the CHS program.

·   You must be a member of or descendant of a federally recognized Indian Tribe

·   Provide appropriate documentation such as a Certificate Degree of Indian Blood (CDIB) or birth certificate reflecting descendency from otherwise enrolled tribal member.

·   You must reside in the CHS service area.

·   Provide proof of residency (water, electric, gas, propane, home phone, or cable)

Also Eligible Individuals:

·   Full-time boarding school, college, vocational, or other academic students who may temporarily not residing in the CHS service area for their education.

·   A person who is temporarily away from the service area due to things such as travel and employment.

·   Indian child(ren) placed in foster care away from the service area by order of the court of competent jurisdiction and who are eligible for CHS at the time the court order shall continue to be eligible.

·   Maintain close economic and social ties with the federally recognized tribe or tribes.

Accessing Contract Health Services

A C.H.S. official can only authorize payment for medical care outside an IHS facility if funds are available.  To access payment for services through CHS, a patient must first either have an approved emergency service or referrals. Individuals who receive funds from a pay source considered to be an alternate resource are required to remit that payment directly to the rending provider or CHS. Failure to follow this procedure will result in criminal proceedings. Contract Health Service will always be the pay source of the last resort.

Referrals

Referrals are written by IHS, Tribal, or IHS providers for services. A referral, however, does not constitute authorization for payment until approved by CHS. If funds are not available, the referred service is deferred. CHS must pre-authorize all non-emergency care before receiving medical treatment.

Verification

Patients are to take alternate resources identification with them to their appointment to ensure providers have accurate and appropriate billing information.

Emergency Services

You must contact CHS within 72 hours of receiving emergency care other than at IHS. For an elderly or disabled person receiving emergency care, may be extended 30 days. If a patient is unable to contact CHS, a person acting on their behalf must contact CHS within the same time limits. CHS must approve all non-emergency care before receiving medical treatment. Emergency services may be approved for payment or denied. Patient must follow up with a Kickapoo Provider.

Alternate Resources

All patients are encouraged to apply for all resources available to them such as:

  • Medicaid
  • Medicare
  • Worker’s Compensation
  • Auto Insurance
  • And other personal injury or liability coverage

All Medicare-eligible patients are strongly encouraged to apply for Medicare at the age of 65 years or more. Please see elders care, representative, Juanita Johnson if you need assistance with applying for Medicare.

CHS Staff and/or benefits coordinator can assist with the application process for other resources. Failure to apply for alternate resources can result in denial of payment.

Claims Coordination

Patients are to provide the CHS office copies of the following documents for claims processing:

  • Alternative resources payment information
  • Explanation of benefits report
  • Remittance statements/reports
  • Other documentation of payments
  • Responses to an application for alternate resources
  • Medical Records

Denials

If your request for CHS funding is denied, you will receive a letter informing you of denial. Sometimes all that is needed is more information. If you already went to a non-Indian health Service provider for your care a letter of denial for payment will also be sent to them. You have 30 days to request reconsideration in writing. Address your letter to the CHS address listed at the bottom of the denial letter.

Unfortunately, the federal government has never passed a law that says that Indian Health Care is an entitlement program like Medicare or the Veterans Administration. As entitlement programs, Medicare and the VA essentially have an open-ended budget. The Indian Health Services has the specific allocated amount of dollars and regardless of the healthcare needs the dollars to remain the same. When the funding is inadequate, the IHS and Tribes are forced to limit services through medical priorities, and that is mainly why there are never enough funds to cover ALL the medical needs of the Indian patients.

Contact Us

Telephone: (405)964-5824
Fax : (405)964-2217