ABOUT

The mission of CorrectCare - Integrated Health is to provide healthcare management and operational processes to improve overall quality of care in a cost effective, quantitative manner.

CorrectCare - Integrated Health (CCIH) was formed in September, 1996 by two individuals interested in leveraging management and utilization review to provide high quality, cost efficient healthcare for the correctional industry. With over twenty years of benefit design in the private sector, our company chairman identified the need for this same type of oversight and cost control within the correctional marketplace. The continuing goal of our company is to focus on medical management for correctional institutions.

Our Experience:

Since 2003, our company has provided utilization management, network access, and claims processing services solely within the correctional environment. Our company has experience with providing utilization management and claims management for small local facilities, and entire state department of corrections. Our experience also includes working hand-in-hand with state correctional personnel to provide necessary data for accreditations through the American Correctional Association (ACA).

Our Difference:

Our innovative approach to the needs of the correctional industry is a hybrid of public and private practices. Our services are grounded in nationally accepted guidelines combined with elements unique to the correctional industry, and are further tailored to the individual policies of each correctional client. Our management support and processes ensure that our clients have all the tools required to be good stewards of their ever-strained financial resources.

Our company takes an integrated, holistic approach in providing both quality and cost effective care to the inmate population. Not only does this include on-site care but also when the use of off-site providers is medically necessary and appropriate. With current clients, our comprehensive approach integrates the medical care at the facility with electronic medical records, and corrections specific utilization review and case management. These elements are invaluable in the accreditation process and in the continuity of medical treatment when an inmate has to be taken offsite for care. The cost of outside care is further controlled by the use of a preferred provider network and claims processing. Our preferred provider network assures that charges for off-site care are discounted and do not exceed usual, customary, and reasonable rates (UCR). And finally, we integrate utilization review with claims processing to insure that only off-site and specialty treatments that are medically necessary and that have been properly authorized are paid.

Our approach is more cost-effective than the traditional correctional medical service that vendors have typically offered. In addition, we believe the quality and continuity of care is better. Using our approach, we have helped the Kentucky Department of Corrections save $100 million in offsite medical costs over the past seven years.

Accreditation – All eleven Kentucky institutions where we have staffing have ACA accreditation. Many of our staff members participate in this process, particularly the Nurse Service Administrators.

To summarize, in our company’s short history, we:

1. Implemented a statewide preferred provider network, allowing for discounted pricing as well as increased ability for smaller and rural prisons to use local providers for treatment options.
2. Developed comprehensive correctional specific third party administration services for medical claims.
3. Implemented a prior authorization and inpatient review program which reduced hospital length of stays from greater than 6 days to about 4 days.
4. Implemented a statewide correctional specific electronic medical records (EMR) system in seven months.
5. Recruited, filled, and maintained 205 healthcare positions in eleven institutions.
6. Selected as the vendor to bring the California Prison Health Care Services (CPHCS) claims payment process into one that meets industry standards.

As many are aware, California has experienced multiple crises related to inmate health care provision and payments. Since the time of complete transition of TPA services in October of 2009, we have assisted CPHCS with the elimination of a massive backlogged claims inventory and are currently submitting claims to their accounting system in a timeframe which allows them to meet California prompt payment act provisions for medical claims. Recently, the contract was renewed for the first of three available extensions.