Pokagon Band citizens who are eligible for PRC funding and whose dental, optical, and medical needs are such that they need to be referred to outside clinics or services must first be seen in the Clinic to establish one of the providers as their primary care provider. They must be willing to transfer all care to Pokagon Band Department of Health Services and update all information and records at the Clinic.
Referrals must be medically necessary and of a nature that the need cannot be met in the Clinic. All referrals to outside providers are reviewed by the Medical Care Review Committee (MCRC), which meets every other week. This interdisciplinary committee provides oversight and direction to providers and payers for medical referrals, and makes the ultimate decisions regarding payment for outside services, following PRC priorities and guidelines. All dental, optical and medical services provided outside the Pokagon Band Department of Health Services must have prior authorization by the MCRC.