10.20.160 Denial.
(1) If a person is denied enrollment in PRC Services or payment by Samish PRC, the Samish Health Director must:
(a) Notify the person in writing of the denial;
(b) Include a statement containing all the reasons for the denial and the process for administrative review of the denial;
(c) Advise the PRC enrollee of the administrative review process and the availability of an advocate;
(d) If the provider may reasonably believe the Samish Indian Nation is responsible for payment, also send the notice to the provider.
(2) Records. The Samish Health Director must create and maintain a file on each denial of PRC. The file will contain all correspondence and relevant information as outlined in these policies and procedures and will be maintained for a period of seven years. [Res. 2020-10-013 § 2, 2020.]