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Corrections

Managing Offsite Inmate Medical Costs with Transparency and Results

The Growth Of Comprehensive Prison Healthcare.

The United States Supreme Court ruling in Estelle v. Gamble, 429 U.S. 97, 97 S.Ct. 285 (1976), affirmed that prison inmates have a “constitutional right” to healthcare, establishing the foundation of the inmate healthcare industry. By 2009, the nationwide prison healthcare market exceeded $9.3 billion annually. While large facilities often secure comprehensive care, smaller county jails face unpredictable offsite medical expenses that strain budgets and complicate planning.

Unpredictable Costs, Reliable Solutions

Among all correctional expenses, offsite inmate medical costs are some of the most unpredictable and hardest to plan for. Although they can’t be eliminated, they can be effectively reduced and managed—and that’s where we come in.

Why We Are Different

Experienced Since 2011

Focused Expertise

No Hidden Fees

Aligned Incentives

Experienced Since 2011
With over a decade in the industry, our experienced team has worked on both sides of corrections—serving as Sheriffs or Jail Administrators and now supporting counties in reducing medical costs.
Focused Expertise
We exclusively process offsite inmate medical claims—nothing more, nothing less.
No Hidden Fees
We believe in clear, upfront pricing with no hidden costs. Our simple administrative fees are transparent, and there are no cost pools - so you always know exactly what you're paying for.
Aligned Incentives
Our fees are earned solely from the savings we generate, meaning our success is directly tied to yours.

Why We Are Different

Experienced Since 2011

With over a decade in the industry, our experienced team has worked on both sides of corrections—serving as Sheriffs or Jail Administrators and now supporting counties in reducing medical costs.

Focused Expertise

We exclusively process offsite inmate medical claims—nothing more, nothing less.

No Hidden Fees

We believe in clear, upfront pricing with no hidden costs. Our simple administrative fees are transparent, and there are no cost pools - so you always know exactly what you're paying for.

Aligned Incentives

Our fees are earned solely from the savings we generate, meaning our success is directly tied to yours.

Let Us Show You

  • Proven Experience
  • Transparent Savings
  • Tailored Solutions
proven-experience
Proven Experience

Our team’s first-hand knowledge of corrections operations ensures we understand your challenges and priorities. With years of expertise in inmate medical billing, we streamline processes to maximize efficiency and savings.

transparent-savings
Transparent Savings

You’ll always know what you’re paying for and how much you’re saving. Our straightforward approach eliminates uncertainty, providing clear reporting and accountability every step of the way.

tailored-solutions
Tailored Solutions

We help counties manage unpredictable offsite medical expenses with clarity and confidence. Our customized strategies adapt to your county’s unique needs, ensuring cost-effective solutions without compromising quality care.

Real-Life Savings:
How Counties Have Cut Costs on Medical Bills

NCSA-logo
County In
North Carolina
  • Type of Bill:
    SEPSIS
    DUE TO MRSA
  • Intially Billed:
    $416,004.90
  • Negotiated Prime Savings:
    $343,711.17
  • Total Paid:
    $72,293.73
  • Total Savings:
    82.6%
We Helped Achieve
82.6% Savings!
NCSA-logo
County In
North Carolina
  • Type of Bill:
    LYMPHOMA AND NONACUTE LEUKEMIA
  • Intially Billed:
    $289,495.89
  • Negotiated Prime Savings:
    $250,917.92
  • Total Paid:
    $38,577.97
  • Total Savings:
    86.7%
We Helped Achieve
86.7% Savings!
Florida_Sheriffs_Association_Logo
County In
Florida
  • Type of Bill:
    AIR AMBULANCE
    BILL
  • Intially Billed:
    $291,626.20
  • Negotiated Prime Savings:
    $261,036.52
  • Total Paid:
    $30,589.68
  • Total Savings:
    89.5%
We Helped Achieve
89.5% Savings!
Florida_Sheriffs_Association_Logo
County In
Florida
  • Type of Bill:
    ATRIOVENTRICULAR BLOCK COMPLETE
  • Intially Billed:
    $223,817.91
  • Negotiated Prime Savings:
    $205,457.43
  • Total Paid:
    $18,360.48
  • Total Savings:
    91.8%
We Helped Achieve
91.8% Savings!

Corporate Partnerships

Florida Sheriffs' Association
North Carolina Sheriffs' Association
Kentucky Jailers Association
South Carolina Sheriffs' Association

Inmate Medical Cost Containment Program

Knowing that an expert is working hard to save you the maximum dollars on inmate health care allows you to focus your time on other important jail administrative duties. We compliment an on-site medical company, allowing them to do what they do best (on-site care) while we do what we do best (saving you dollars on the off-site care inmates needed). Having a cost management system shows that the county is focused on providing appropriate medical care regardless of the cost. And our reporting supports you in the endeavor to be knowledgeable and accountable for the health care of your inmates.

Bill Processing Overview

  1. PHS Subscriber ID Cards are provided to be taken with the inmate to the medical provider
  2. PHS receives the claim, and verifies the County’s responsibility
    • If the claim is received directly from County, it will be considered approved.
    • If received from the medical provider, County approval may be needed.
  3. PHS “scrubs” and applies bill review adjustments for each claim to remove coding errors, erroneous charges, and adjusting per industry-specific standards.
  4. PHS then applies the agreed-upon discount (via in-network provider, or individual claim negotiation).
  5. PHS invoices the County (provider allowed amount, plus admin fee).
  6. County pays PHS for all open invoices, via ACH (instructions enclosed) or by check.
  7. PHS pays the medical provider their total amount owed.
1

ID Cards Issued

PHS Subscriber ID Cards are provided for use with medical providers.

2

Claim Verification

PHS receives bills and verifies the County's responsibility.

3

Bill Scrubbing

PHS uses proprietary software to remove coding errors and erroneous charges.

4

Discount Applied

Agreed-upon discounts are applied (in-network or negotiated).

5

Invoice Sent

PHS invoices the County for the provider amount plus a fee.

6

County Payment

County pays PHS for all open invoices via a single payment.

7

Provider Payment

PHS pays each medical provider their owed amount.

Inmate Medical Claim Edits - Renovo

  • Medical Bill Review
  • Scrubbing Claim/Bill Edits
  • Medicare Repricing
  • UCR (Usual Customary Review) Repricing
  • Negotiations
  • Implants (Prime Surgical Implant)
  • Fair Market Pricing (FMP+)
  • State & Federal Fee Schedules
  • Medical Treatment Guidelines, Official Disability Guidelines (ODG)
Medical Bill Review

Renovo, our proprietary bill review software, offers clients an application that is integrated with PPO Networks along with coding reviews, duplicate detection, and industry specific adjustments. This seamless program gives you rapid turnaround time, online access, customized features and reporting, and competitive pricing options.

Scrubbing Claim/Bill Edits

“Bill Edits” is defined as scrubbing edits from CMS, AMA, or any other medical source and applied to an individual bill. 

Medicare Repricing

Prime Health systematically stores and maintains up-to-date Medicare pricing methodologies, ensuring our clients have access to benchmark pricing and the capability to reprice services in alignment with nationwide Medicare rates. 

UCR (Usual Customary Review) Repricing

Prime Health manages a comprehensive UCR (Usual Customary Review) database to provide our clients with access to benchmark pricing and the ability to perform repricing according to UCR standards on a national scale. 

Negotiations

The Prime Health negotiations solution utilizes our very own qualified negotiations professionals who pay close attention to medical charge billing while thoughtfully and expeditiously researching and negotiating bills for appropriate level of payment. 

Implants (Prime Surgical Implant)

This solution meticulously assesses surgical implants through six essential savings and reduction modules, aiming to greatly reduce costs and offer clear insights into trends that inform medical managers. Prime’s data-driven systems improve pricing transparency and objectivity for surgical implant devices. Our comprehensive evaluations guarantee fair reimbursement, providing clients with robust assurance and support for their pricing strategy. 

Fair Market Pricing (FMP+)

The Prime FMP + methodology will be deployed based solely upon pre-established and mutually agreed to parameters, such as state, provider type, bill type, bill amount, etc. 

The methodology applied is based on annualized reimbursement data from a nationwide dataset of average and accepted reimbursements, reported cost data, historical charge reports and negotiated results for each bill. 

State & Federal Fee Schedules

Prime Health efficiently maintains current State and Federal Fee Schedules within a robust database, enabling our clients to access repricing options that adhere to regulatory requirements across various states and federally mandated programs. 

Medical Treatment Guidelines, Official Disability Guidelines (ODG)

Leveraging ODG’s industry-leading medical treatment and return-to-work protocols, along with an extensive drug formulary for workers’ compensation, our solutions integrate evidence-based medical literature with advanced claims data analytics. This synergy optimizes outcomes by ensuring appropriate intervention levels tailored to individual cases. 

Testimonials:

2022-Sheriff-Staly-Official-Photo-FINAL2
Sheriff Rick Staly
Flagler County, Florida
jason bennett
Jason Bennett
Director of Business Development NC Sheriffs' Association
Sheriff Stanek
Sheriff Rich Stanek, (Ret.)
Past President, Major County Sheriffs of America
Vice President, National Sheriffs’ Association
steve casey
Steve Casey
Honorary Sheriff,
Retired Executive Director, Florida Sheriffs Association (2010-2025)
Sheriff Rick Staly
Flagler County, Florida

We are always looking for programs and grants that save our residents money and the Offsite Inmate Medical Savings Program has proven to be a tremendous benefit.

This program has enabled our award-winning detention facility to meet the medical needs of our inmates while significantly saving our residents money at the same time. In just two years we have saved taxpayers over $2 million!

Jason Bennett
Director of Business Development NC Sheriffs' Association

In the area of offsite inmate medical claims, controlling costs while ensuring quality care is a constant challenge. Prime Health Services has consistently proven to be a reliable and efficient partner in this regard. Their comprehensive network and proven cost-containment strategies have led to significant savings for numerous counties, alleviating budgetary pressures and allowing resources to be allocated to other essential areas of public service. Their expertise in navigating the complexities of inmate healthcare has been a game-changer for us.

The Association’s partnership with Prime Health Services has led to improved efficiency and substantial financial savings. I have full confidence in their ability to provide the same level of service and value to your organization. If you are looking for a partner that is dedicated to helping you control medical costs while maintaining high standards of care, I cannot recommend Prime Health Services highly enough.

Sheriff Rich Stanek, (Ret.)
Past President, Major County Sheriffs of America
Vice President, National Sheriffs’ Association

As a longtime law enforcement leader, I’ve seen firsthand how rising inmate medical costs can strain a county’s budget. Prime Corrections has developed a smart, effective solution to that problem. Their inmate medical cost containment services deliver real, measurable savings for counties—without compromising the quality of care.

By leveraging their national network and proven processes, Prime Corrections consistently reduces the burden of off-site medical expenses, giving sheriffs and county officials the ability to better allocate limited resources. I’ve recommended their services to many colleagues across the country, and I continue to advocate for their work. When you see the savings and support they provide, joining their program is a no-brainer. They’re a trusted partner in protecting both public safety and taxpayer dollars.

Steve Casey
Honorary Sheriff,
Retired Executive Director, Florida Sheriffs Association (2010-2025)

While I served as the Executive Director of the Florida Sheriffs Association, I had the pleasure of working with Prime Health Services (PHS) to develop a unique program aimed at helping sheriffs reduce their costs for out-of-facility inmate health care. Health care costs are a major concern for those operating jails and correctional facilities and have increased significantly over the past three decades.

As part of their service, PHS ensures that duplicate charges are removed from medical bills and that substantial discounts are applied to the remaining charges. Since its inception, this program has saved Florida sheriffs and taxpayers millions of dollars annually.

I highly recommend PHS to any state sheriffs' association or individual sheriff seeking a cost-effective and efficient solution to reduce inmate health care expenses. The team at PHS is highly professional, and if they don’t save you money, you don’t owe them anything—making the service essentially cost-free to the agency. It’s a true win-win with no catch.

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Meet Our Corrections Team

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Andrew Debroux
Director of Corrections
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Roger Kelton Headshot
Roger Kelton
Corrections Sales Representative
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Mark Shook
Corrections Sales Representative
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Nico F. DiGioia
Corrections Sales Representative
Email Me
Jason Gray
Account Manager, Corrections
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Isabel Burcher
Operations Specialist, Corrections
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Georgia Deffner
Operations Specialist, Corrections
Email Me
Grace Geeting
Operations Specialist, Corrections
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Phone:
(866) 348-3887
Email: Corrections@primehealthservices.com

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331 Mallory Station Rd.
Franklin, TN 37067
866-348-3887
info@primehealthservice.com

Technology Solutions

  • Renovo
  • What is Renovo
  • What Makes Us Unique

Markets

  • Workers' Compensation
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  • Auto Casualty
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  • Nominate a Provider
  • State Compliance
  • Client FAQ

Providers

  • Join the Network
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  • Claim Disputes
  • Reimbursements

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