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Prime Health Services

Our Services

Inmate Medical Cost Containment



Prime Health Services is a leader in managed care, and part of that medical cost containment focus is for the corrections industry. Our ability to offer comprehensive programs for jails and prisons of any size is what puts us on the cutting edge of the healthcare sector. 

For inmates that need off-site medical care, we are able to offer you our network of medical providers whether that be x-ray facilities, dentists, chiropractors, optical offices, or hospital services. When going to an in-network medical provider, we are able to save the sheriff's office money on the bill. Even if the sheriff's office already has a discount with the local hospital, we may have a better negotiated rate and, in addition, we also have a broader network that provides coverage if an inmate needs services not provided by that local hospital.

 Easy, Free Program

Our inmate off-site medical cost containment program doesn't cost the sheriff's office money, it saves money. And time.

  1. When an inmate needs off-site medical service, simply call the toll-free number to pre-verify the service. The sheriff's office will present a PHS identification card to the medical provider to ensure they have the correct billing information. 
  2. After treatment, the bill is sent directly to PHS and we process the claim for you. The bill is "scrubbed" by our state-of-the-art software to ensure only appropriate claim charges on the bills are reimbursed. Scrubbing is performed at the detail line level and includes industry standard edits such as unathorized / inappropriate services on the claim, incomplete claims, duplicate claims, invalid or excessive codes, and unbundled charges. 
  3. After the claim has been processed, the sheriff's office will receive an invoice from Prime Health Services. The sheriff's office will write PHS a check for any invoices received. Once full payment is received by PHS, we will pay all of the providers of those claims for the sheriff's office taking that burden off of your staff. 

The sheriff's office "pays" for the program through a percentage of savings from the medical bill. Prime Health Services doesn't get paid unless we save the sheriff's office money. 

 Off-site National Provider Network

Prime Health Services offers the corrections industry access to our network of directly contracted medical providers. We are experts at direct contracting with providers and have taken our experience in the workers' compensation and group health industries to help the corrections industry save money on medical care. 

Even if you have an on-site medical in place, we are your off-site experts. Our proprietary software that scrubs bills for accuracy and savings offers unparalleled service even if your on-site staff say they can assist with off-site claim processing. 

  • Offers better coverage for your facility - providers that are willing and have contracturally agreed to see inmates (there's no confusion)
  • Receive deeper discounts from medical providers based off of our negotiated contracts
  • Reports are customized to benefit you and your facility
  • Option for MedTrack integration that ties our nationwide off-site provider network to our online tool for managing your inmate population's medical incidents

 Online Inmate Medical Tracking

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.

 WEB BASED      COMPREHENSIVE      CUSTOMIZED     TECHNOLOGY BASED

  

 Claims Management

  • Identifies and tracks trends in your off-site care utilization and costs.
  • Claims Auditing
    -Eliminating duplicate claims
    -Identifying coding errors
  • Claims Processing - 2 ways you can access the Prime Health Provider Network

 Real-time EDI Solutions

  • One of the first to market with this technology
  • Claims are processed within seconds of being received (not hours or even days)
  • Allows Prime Health to capture data for all types of analysis for you

 Renovo System

  • Enables us to easily and quickly put our network into our clients' hands.
  • Increased reporting capabilities

 Utilization Management

  • Continual quality improvement with controlled costs

 Utilization Review

  • Provides you with an independent review of medical cases to help ensure cost-effective, clinically appropriate care

 TPA Services

  • Accurate billing with audit checks
  • Fast turnaround to pay providers quickly
  • Accessible online reporting of savings so you know what the claim cost and savings are at any point in time