FOR MEMBERS OF THE TOHONO O’ODHAM NATION
As of October 1, 2015, Gila River Health Care (GRHC) must make changes in the way we handle referrals and payments for medical services that are provided by off-site private hospitals, physicians, and other providers (sometimes called Purchased Referred Care PRC).
Gila River Health Care will not be able to pay for emergency and non-emergency care provided outside the Gila River Health Care system. Your eligibility will be considered Direct Only; which means that you remain eligible to receive any direct care services (i.e. Primary Care Department, Behavioral Health, and Physical Therapy) at any Gila River Health Care facility.
This change also affects you if you are an enrolled member of a federally recognized tribe and married to or a dependent of an enrolled member of the Tohono O’Odham Nation.
• As of October 1, 2015, Gila River Health Care will no longer pay for emergency and non-emergency care provided outside the Gila River Health Care system this includes: Co-Payments, Coinsurance and/or Deductibles.
• If you reside in Pinal County, call Neil Foster with the Santa Rosa Clinic at (520) 279-0953 or (520) 361-2403 Ext. 6027 with any questions regarding Purchased Referred Care.
• If you reside in Maricopa County call Darlene Yazzie with Phoenix Indian Medical Center at (602) 263-1569 with any questions regarding Purchased Referred Care.
• Tohono O’Odham Nation members living within the Gila River Indian Community (GRIC), the AK-Chin Indian Community, or any enrolled Tohono O’Odham member married to an enrolled GRIC member or AK-Chin member will NOT be affected.
• Tohono O’Odham Nation members covered by the State Medicaid (AHCCCS/AIHP) or Gila River Long Term Care will not be affected; if a referral is written by a Gila River Health Care provider, as a courtesy, the Purchased Referred Care Department will schedule your appointment.
For more information, call the GRHC Purchase Referred Care Department (formerly Managed Care) at (520) 562-7997.