Corrections
Managing Offsite Inmate Medical Costs with Transparency and Results
The Growth Of Comprehensive Prison Healthcare.
Unpredictable Costs, Reliable Solutions
Why We Are Different
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
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.
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.
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
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%
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%
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%
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%
Corporate Partnerships
Inmate Medical Cost Containment Program
Bill Processing Overview
- PHS Subscriber ID Cards are provided to be taken with the inmate to the medical provider
- 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.
- PHS “scrubs” and applies bill review adjustments for each claim to remove coding errors, erroneous charges, and adjusting per industry-specific standards.
- PHS then applies the agreed-upon discount (via in-network provider, or individual claim negotiation).
- PHS invoices the County (provider allowed amount, plus admin fee).
- County pays PHS for all open invoices, via ACH (instructions enclosed) or by check.
- PHS pays the medical provider their total amount owed.
ID Cards Issued
PHS Subscriber ID Cards are provided for use with medical providers.
Claim Verification
PHS receives bills and verifies the County's responsibility.
Bill Scrubbing
PHS uses proprietary software to remove coding errors and erroneous charges.
Discount Applied
Agreed-upon discounts are applied (in-network or negotiated).
Invoice Sent
PHS invoices the County for the provider amount plus a fee.
County Payment
County pays PHS for all open invoices via a single payment.
Provider Payment
PHS pays each medical provider their owed amount.
Inmate Medical Claim Edits - Renovo
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Medical Bill Review
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Scrubbing Claim/Bill Edits
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Medicare Repricing
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UCR (Usual Customary Review) Repricing
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Negotiations
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Implants (Prime Surgical Implant)
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Fair Market Pricing (FMP+)
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State & Federal Fee Schedules
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Medical Treatment Guidelines, Official Disability Guidelines (ODG)
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.
“Bill Edits” is defined as scrubbing edits from CMS, AMA, or any other medical source and applied to an individual bill.
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.
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.
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.
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.
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.
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.
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:
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!
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.
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.
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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Phone:
(866) 348-3887
Email: Corrections@primehealthservices.com
