Frequently Asked Questions
Contract Health FAQs
- What is Contract Health Services?
A federally funded (and some instances tribally funded) program that assists with payments to “outside” medical facilities/physicians for services received by an eligible American Indian/Alaska Native and Non-Native patients.
Assistance depends on eligibility, residence, medical priority, alternate resources and availability of funding.
We are not an insurance company!
- Who is eligible for CHS?
Anyone who can provide proof that they are a member of a federally recognized tribe.
Tribal Citizenship Card
Certificate of Degree of Indian Blood (CDIB) Card
Verification Letter from Tribal Citizenship Office
Non-Native woman pregnant with an eligible Indian’s child.
Eligible individual must have a permanent address within CHSDA area.
- How do I get a referral?
Must be seen by a doctor at a Tribal or IHS facility. That physician will then determine if outside services are needed for the patient.
If the patient was seen by an IHS or Tribal physician outside their CHSDA area; that facility must fax the referral to appropriate CHS office.
Eligible person went to a non-Tribal/IHS Emergency Room or Hospital for care, that patient or guardian must call in to proper CHS office within 72 hours or 30 days for elders.
**A referral is not a guarantee of payment for services, it is a request for payment for services.**
- If I’m eligible, why aren’t my bills getting paid?
For questions on payment, contact your coordinator/tech
- What do I do if my referral was denied?
All denied referrals can be appealed!
The patient or someone acting on behalf of patient has 30 days from date of the denial letter to submit an appeal letter to the Creek CHS department.
Appeals are reviewed and processed to Medical Appeal Committee.
Medical Appeal Committee meets the 2nd Wednesday of the month.
After review of the Appeal Committee, a letter is mailed to patients and vendors with the decision of the Appeal.
Referrals can be appealed up to 2 times with written letters/documentation.
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