Member Services – (formerly PRC)
The Paiute Indian Tribe of Utah and FourPoints Health now have a dedicated Member Services Team that offers insurance enrollment assistance, and prior authorization referral care services (formerly PRC) for qualifying Tribal Members and their families.
If you are new to this service, please take a moment to review eligibility criteria and information below.
You can contact the team via the chat/help app in the lower right, or call: 435.201.5747
Office Hours: Monday – Friday, 8:00 am – 5:00 pm Mountain Time.
**If you require after hours assistance, please select option 3 for the on-call provider when prompted**
NEW PITU HEALTH CARDS!
The new insurance cards for Paiute Indian Tribe of Utah (PITU) Purchased/Referred Care (PRC), which will be known as PITU Health moving forward, are now available.
For more information, click the button below. If you have questions, please contact Member Services at 435-201-5747.
PROCESSES: BILL UPLOAD OR APPEALING DENIED SERVICES
If you have received a bill for an authorized service, please upload it below.
If you believe you have received a bill for a denied service and feel it should be covered, please submit a claims appeal by filling out the form below.
For questions on the appeals process, please call: Angie Searle, 435-201-5747 ext. 4107
PURCHASED REFERRED CARE (PRC) FLOWCHARTS
If you are PRC-eligible, before you seek care outside of FourPoints Health, please check out the flowcharts below to make sure we can process any claims as quickly and efficiently as possible.
If you have any questions, please contact Member Services via the information at the top of this page.
ELIGIBILITY REQUIREMENTS
PITU Member Living in PITU Service Area
Documentation required:
- Membership verification.
- Proof of residency. Must live within Iron, Millard, Sevier or Washington Counties.
PITU Member Away at School
Documentation required:
- Proof of tribal enrollment (CIB, Tribal ID).
- Proof of full-time school enrollment (official school document).
Pregnancy Eligibility
Documentation required:
- Proof of pregnancy from FourPoints Health clinic.
- Proof of eligible father’s PITU tribal enrollment (CIB, Tribal ID).
- Proof of PRC eligibility for father.
Married to a PITU Member Living in PITU Service Area
Documentation required:
- Marriage Certificate (Must be legally married).
- Proof of PRC eligibility for spouse.
Child Eligibility
Documentation required:
- Proof of parent PRC eligibility.
- Only eligible until 19th birthday.
- Proof of legal guardianship.
PITU Member Moving Outside of PITU Service Area
Documentation required:
- PRC Eligible for 180 days after moving outside of PITU Service Area.
- Proof of PRC eligibilty during residence within PITU Service Area.
PITU Member Moving Back into PITU Service Area
Documentation required:
- Proof of residence within PRCDA (qualified service area) for at least 90 days (Utility bill, rent agreement, tax records).
PITU Foster Child Living Outside of PITU Service Area
Documentation required:
- Proof of tribal enrollment (CIB, Tribal ID).
- Proof of living in service area when placed in care.
- Proof of legal guardianship for Foster Care.
Member of a Federally Recognized Tribe Living on PITU Reservation Lands
Documentation required:
- Proof of tribal enrollment (CIB, Tribal ID).
- Proof of address (Utility Bill, Rental Agreement, Notarized letter stating member is living with said person.
Non-Native with Communicable Disease Living in Eligible PITU Member Household
Documentation required:
- Proof of disease.
- Proof of residency.
Native Member of another Federally Recognized Tribe who Works for the Tribe
Documentation required:
- Proof of tribal enrollment (CIB, Tribal ID).
- Proof of employment for the Tribe.