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Corrections

The Growth Of Comprehensive Prison Healthcare.

The United States Supreme Court ruled in Estelle v Gamble, 429 U.S. 97, 97 S.Ct. 285 (1976) that prison inmates had a “constitutional right” to health care access. Inmates at that time were the only people in the United States to be guaranteed health care, and thus an industry was born. In 2009, the nationwide prison healthcare market was estimated to be in excess of 9.3 billion dollars annually.

For state prisons and large county jails, comprehensive prison healthcare companies generally provide on-site (staffing) and off-site health care. But county jails across the country serve a large number of inmates that are entitled to quality health care as well and they do not have as many resources as larger facilities.

Prime Health Services, a leader in managed care, has a mission to control the ever growing health care costs experienced in the United States and has a solution for the corrections industry to help decrease inmate / prisoner medical costs. Our ability to offer comprehensive programs for jails and prisons of any size is what puts Prime Health Services on the cutting edge of the healthcare sector.

Corporate Partnerships

INMATE MEDICAL COST CONTAINMENT PROGRAM

We understand that one of the most nebulous areas of a county budget is the jail and trying to project inmate medical costs. Inmate medical costs are difficult to plan for when you don’t know when a massive heart attack or other injury will happen.

INMATE MEDICAL CLAIM EDITS

For jail administrators and sheriffs who are interested in maximizing savings on medical claims, we offer our state-of-the-art, seamless claim review technology that delivers maximum savings on inmate off-site medical claims.

MEDTRAC

Medtrac inmate medical tracking system is Prime Health Services’ online tool for managing your entire inmate population’s medical incidents from beginning to end with comprehensive solutions for budgeting, tracking, and scheduling.

Offsite Inmate Medical Savings Program

In 2012, the Florida Sheriffs Association introduced the Offsite Inmate Medical Savings Program to address the issue of offsite inmate medical expenses. The Offsite Inmate Medical Savings Program is designed to supplement onsite medical services and does not entail any enrollment fees. Sheriffs or county-operated jails are only charged for the service if savings are realized. A share of the savings is used to cover the expenses related to the negotiation and thorough examination of medical bills for offsite inmate medical care.

Outcome Based Metrics

The PHS Preferred Provider Organization (PPO) Network is a nationwide network of medical providers that encompasses those that are willing and able to work with the inmate/prisoner population. This corrections specific network of medical providers allows the sheriff’s office or prison facility to have comprehensive coverage of off-site medical services at a discounted rate, thereby lowering the total cost for off-site medical services. In addition, we have developed proprietary software for medical bill review, claims adjudication, and appointment setting.

The claims adjudication software “scrubs” the bills to prevent duplication of claims, ensure proper medical coding, and to confirm only appropriate claim charges on the bills are reimbursed which lowers the actual cost of the bill by a factor. We also offer outcomes-based metrics for the corrections population, which drives the medical costs down further by identifying the best outcomes at the best price.

Working with us is easy.

Prime Health Services is in the position to work with facilities in any of the following ways:

  • contract for off-site health care directly
  • contract for off-site health care working with an on-site prison healthcare provider
  • lease the PHS provider network to other contractors or prison owners/management companies

Because we are a national PPO network, we are able to provide coverage in any state and can break the network down to the county level so you know how many physicians and other medical providers are “in-network” in your area. If there are providers you like to work with that are currently not in-network then our Provider Contracting Department gets to work negotiating directly with the provider(s) to achieve the deepest possible discount for the sheriff’s office or prison facility.

We Bring You Savings.

Prime Health Services is in a distinctive position to provide savings on inmate off-site medical services by leveraging its preferred provider (PPO) network and overall healthcare cost containment experience to lower the costs of off-site inmate medical bills.