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.