Policies and Forms

To eliminate confusion listed below are forms that pertain to members of the Paiute Indian Tribe of Utah. Those who are eligible to recieve Contract Health Services and Purchased Referred Care.

pdfContract Health Services (CHS) Application for Alternate Resources
pdfContract Health Services (CHS) Claims Payment Policy
pdfContract Health Services (CHS) CPAP BIPAP Policy and Procedure
pdfContract Health Services (CHS) Per Diem and Mileage Reimbursement Policy
pdfContract Health Services (CHS) Prior Authorization Process Policy

General information for Tribal and Non-Tribal members:

 
  

Behavorial Health Forms