Health

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These services are available to Tribal Members who live off island at conveniently appropriate locations that will be announced on a monthly basis with days and times via the Tribe’s website on the Health Department page. If you wish to receive Tribal updates by email, or you need to update your current mailing address please send email to:        membership@wampanoagtribe.net.


PRC Registration:  those who fall under the PRC umbrella must register with in the specific time frame that falls:  within the one month before your birthday; during the month of your birthday; or (at the latest) within the one month after your birthday.  This registration must be completed each year in order to keep your benefits current, because the Wampanoag Health Service is responsible for the funds expended for your care.  Prescriptions are reimbursable; however, other services must be called in, in advance, to obtain a Confirmation Number for tracking purposes. A Confirmation Number is not a guarantee for payment or reimbursement.


DR NOLAN CLINIC

MONDAY, SEPTEMBER 16                 12:00 p.m.—5:00 p.m.

MONDAY, OCTOBER 14                     12:00 p.m.—5:00 p.m.

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PLEASE REMEMBER TO COME IN FOR YOUR YEARLY ENROLLMENT  YOUR WHS/PRC/HAS HEALTH REIMBURSEMENT BENEFITS.

Required documents: TRIBAL ID, ALL HEALTH INSURANCE CARDS, AND UTILITY BILL FOR PROOF OF RESIDENCY

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WATCH FOR INFO REGARDING AN OFF-SITE CLINIC- TENTATIVELY IN
OCTOBER!!!  MORE DETAILS TO COME!!!

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As we near the close of FY19 on September 30, 2019, and begin our new FY20 on October 1, 2019. Any and ALL “HAS” reimbursement(s) incurred for FY19  must be submitted to CAFETERIA PLAN ADVISORS by OCTOBER 15, 2019.

                               HOPEFULLY YOU HAVE ALL RE-ENROLLED AS REQUIRED.

 Contact Paulette Souza for any questions 508-645-9265 x125


Contact

Catherine Edwards
Direct Services Administrator

Address:
20 Black Brook Road
Aquinnah, MA 02535-1546

Phone: 508-645-9265 x133

Confirmation Line Dukes County: 508-645-9265 x124
Confirmation Line V County: 508-645-9265 x184

Fax :
Medical Fax #: 508-645-2813
Purchase Referred Care (PRC) Fax #: 508-645-2783

Hours:
Monday thru Friday:
9:00 am - 5:00 pm

Staff

F. Ryan Malonson
Purchase/Referral Supervisor
508-645-9265 x127

Tnisha Chandler
Community Health Representative (CHR)
508-645-9265 x129

Christian Brown
PRC Coordinator
508-645-9265 x126

Paulette Souza
Receptionist/Medical Billing Clerk
508-645-9265 x125

Yvonne Michelson
Clinical Nurse
508-645-9265 x122


The Wampanoag Health Service offers three different

types of services to its Tribal Nation!

Direct Care Services

The majority of our direct care on island is offered at the Tribal Administration building within Wampanoag Health Service (WHS). We have a Registered Nurse available to perform urgent care and answer your health related questions. There is also a Medical Doctor who hosts a clinic in WHS on the fourth Monday of each month from 12:00p–5:00p, except during the months when General Membership meetings are held. In those months, the doctor is available from 11:00a–4:00p during General Membership meetings. Dates and times will also be posted in the Toad Rock Times.

Health Access Support (HAS)

The Wampanoag Tribe of Gay Head (Aquinnah) has set funds to assist Tribal members who reside in the United States with the option to register with the Wampanoag Health Service for the annual Fiscal Year (October 1st through September 30th); there is a $1,000 maximum program allotment. Tribal members who have achieved the age of 70 years of youth, only need apply via USPS. We will be glad to send you your forms for enrollment and re-enrollment.

Tribal members only have to register once within the Fiscal Year to be eligible for the allotment. However, you must sign up on an annual Fiscal Year basis.  Tracking and handling of all payments is through a third-party organization by the name of Cafeteria Plan Advisor, Inc. Medical, dental, prescription and vision services are available for reimbursement up to the allotted maximum as noted above. Please contact Clinic Receptionist/Medical Billing Clerk x125 for further information.

Purchased/Referred Care (PRC)

This service offsets the cost of Tribal members who reside within the Service Delivery Area (SDA). Presently, Barnstable, Bristol, Dukes, Norfolk, Plymouth and Suffolk counties within the Commonwealth of Massachusetts are eligible. Residents who reside within these counties are not eligible for the HAS program because they now have the option to be part of PRC. This particular program is dependent upon data of the participants by utilization of the services offered.

The Indian Health Service is the “Payor of Last Resort by Federal Law. Tribal members must utilize all insurance and alternate resources prior to using these funds. It is imperative that you select a provider that is within the network whenever possible.

Payment can include co-payments, deductibles for medical services, dental services, and prescriptions.  If you need assistance in seeking health insurance, selecting an in-network provider or would like to obtain other helpful resources, please contact the Tribe’s Community Health Representative at 508-645-9265 x129.

If your provider does not accept your insurance coverage, the Tribal Member should contact their insurance carrier and request an original receipt of paymentform for submission of your claim and a copy of your Explanation of Benefits. Once your insurance carrier has processed your information and provided these items the WHS/PRC will review all submitted documentation for consideration of reimbursement for charges due, and notify the Tribal Member of its decision.

The Wampanoag Health Service has adopted an Indian Health Service Priority Level system which may limit the amount of services that are available to Tribal members. The purpose of utilizing this system is so the funds granted to us that are allotted within the year are not quickly used up.  

Those who fall under the PRC umbrella must register one month prior, within their Birth Month or the month after each year in order to keep their benefits current as the Wampanoag Health Service is responsible for the funds expended for their care. Prescriptions are reimbursable but other services must be called in, in advance, to obtain a Confirmation Number for tracking purposes. A Confirmation Number is not a guarantee for payment or reimbursement.

Once a Tribal member has been registered and all pertinent information has been obtained and entered into our database, a Conformation Number can be issued for their service as long as the claim falls within the Priority Level. Tribal members who have achieved the age of 70 years of youth, only need apply via USPS. We will be glad to send you your forms for enrollment and
re-enrollment.

For further questions about these services, please contact the Wampanoag Health Service at 508-645-9265 x502.