Payment for health care purchased from non-IHS providers when direct services are not available at KTHC — referred specialty care and emergency services. PRC "is not an Entitlement Program or a guarantee of payment"; referral requests are reviewed weekly, ranked by medical priority and approved to the extent of available funds. Non-emergency care must be pre-authorized before treatment; emergency care at a non-tribal facility must be reported to PRC within 72 hours (30 days for elderly or disabled patients). Non-emergent ER visits are not funded and should be handled at KTHC or a 24-hour IHS hospital in Ada, Lawton, Claremore, Okemah or Okmulgee. PRC is the payer of last resort: patients must apply for Medicaid, Medicare and other alternate resources, with help from the Patient Benefit Coordinator. Denials may be appealed in writing within 30 days.