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Contract Health Care approves after appeal, yet continues to deny care for many

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Editor,

This letter begins where the other one published Dec. 4 in the Valley Journal left off. Here is the letter of reply word for word from the Rockville Maryland office:

“Dear Ms. Peone: I am pleased to inform you that the Billings Area Indian Health Service (IHS) informed me thy have reconsidered your appeal and after review of materials presented in support of your request, have approved payment of purchased/referred care, (formerly known as contract health services), for medical care you received (in November) at the St. Luke Health Care Network in the Community Hospital, Inc. and (in November) at the St. Luke Health Care Network in Ronan, Montana. The Billings Area HIS approved purchase orders for the above-listed providers and payments have been made to them for dates of services indicated. Indian Health Services, Rockville, Maryland 20852.”

If Tribal Health claims they are not connected with Contract Health Care and did not come up with this “Life or Limb Criteria Only,” then take a look at the facts:

• The Contract Care office is located in the Tribal Health building in St. Ignatius. 

• In order to reach a contract worker you call the Tribal Health Line, which is 745-3525, and simply ask for Contract Health Services. 

• Tribal Health hired Dr. Yader to review incoming referrals for patients who may need surgery, a procedure, or a follow up test, and much more. However, he uses the “life or limb criteria only” to base his decision on. 

The biggest question here is why isn’t Tribal Health helping the elderly, the sick, the cancer patients, the heart patients, those whom are on dialysis, and most of the families who have young innocent children appeal here their medical denials? The so-called Million Dollar Clinic isn’t capable of this? Perhaps because they are very much involved with the denials. They can’t appeal —  they are denying.

Char-Koosta did not print my last letter; they said they got it too late. Read the Dec. 4 Journal and figure it out; what do you think? We will see if it gets done next week.

Sharlene Peone
Pablo

 

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