Shawnee Clinic Purchased Referred Care
Absentee Shawnee Tribal Citizens
In the event services are required beyond what is available at ASTHS, your primary provider may refer you for services outside of the clinic. Purchase/Referred Care (PRC) funds may cover the cost for these medical services and some additional services such as hearing aids, orthodontics, and emergency room visits. The expenditure of PRC services is based on medical necessity and current funding level.
Enrolled Absentee Shawnee Tribal citizens who are able to provide proof of residency within the designated catchment areas for the previous 6 months will be eligible to receive services through PRC. AST citizens must reside within the AST catchment areas of Pottawatomie, Cleveland, Oklahoma, parts of Logan and Lincoln Counties.
If you do not have private insurance, PRC will coordinate with outside providers or facilities on your behalf.
If you have private insurance, please notify PRC at least 48-hours prior to your appointment date for a Coordination of Benefits to be sent to the provider.
*Absentee Shawnee enrolled citizens please provide an updated CDIB card.
**In the event that you receive a bill from a provider, please provide a copy to PRC. You may leave bills at the Little Axe Health Center PRC office or Shawnee Clinic PRC office.
In the case of emergency room visits, PRC will need to be notified within 72 hours to determine eligibility for payment and must be medically necessary. Medical priorities have been established for determining which referrals can be authorized for payment. Notification does not assure authorization of payment. However, if you do not notify PRC within 72 hours, your bill(s) will not be paid.
If you do not have insurance, please call the On-Call nurse at405.447.0300, option 9 for triage.
For AST citizens with insurance, evidence must exist that a third-party resource has made the determination such services were “emergency care” or “urgent care.” Such evidence my include payment from private insurance. Federal regulations require that PRC funds are to be used only after all other alternative resources have paid.
*In the event that you receive a bill from a provider, please provide a copy to PRC. You may leave bills at the Little Axe Health Center PRC office or the Shawnee Clinic PRC office.
Other American Indian Beneficiaries
Non-ASTs, who are citizens of other federally recognized tribes, who utilized Absentee Shawnee Tribal Health System services as their primary care facility, and when advanced care is needed - will be referred to their Indian Health Service catchment area.
If ASTHS is your SoonerCare medical home and if you, as a SoonerCare patient, are in need of medically necessary specialty care, our PRC Coordinator can fax the generated referral to the outside specialist and the provider will call the patient to make the initial specialty appointment(s).
*If a referral is for a service not covered under SoonerCare, it is the patient’s responsibility to pay for it.
8:00 a.m. – 5:00 p.m., Monday – Friday
Closed for Holidays
Closed the first Wednesday of the month from 12:00 p.m. to 5:00 p.m.