Sept. 4, 2024
We have updated the claims referral form that Indian Health, Tribal and Urban Indian facilities use to refer American Indian and Alaska Native members on limited cost-sharing plans to a non-I/T/U provider. Be sure to download the new form, or access it from our forms page.
What’s changed? We’ve removed the fax number for pharmacy referrals. All pharmacy referrals should be emailed to the retail service coordinators team.
Why is it changing? The current fax number for pharmacy services is being disconnected, so it’s important to use the updated form with the correct email contact to ensure referrals are processed promptly. If you have printed copies of the previous form, please replace them with the new version.
Reminder: Pharmacy claims are processed when a member fills the prescription at the pharmacy. Members may have to pay out of pocket for prescriptions filled without an I/T/U referral.
Background: American Indians and Alaska Natives on limited cost-sharing plans can get treatment from Indian health care providers at Indian Health Service, Tribal and Urban Indian facilities. But if they need services unavailable through I/T/U facilities, they can get care from a different provider without paying anything out of pocket, if they have a referral.