Correctional Services

Correctional Healthcare Consulting

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Off-Site Services

Off-site services are extremely important for providing a community standard of care for our patients, but they can also be expensive. We’ll support your facility by prioritizing the delivery of primary care on-site, and only sending inmates off-site for care when it is necessary.

We ensure off-site care is necessary by sending requests through a prior authorization process. When the service is approved, CHP coordinates with correctional staff and the provider for security and transportation needs.

Our Account Management Team identifies which providers in the community are comfortable working with inmates. Whenever possible, we bring community providers on-site if they are willing to practice in a jail or prison setting.

Prior Authorization Team

CHP’s Prior Authorization Team ensures that services are medically necessary. It is not about preventing care, it is about providing appropriate care.

When a medical request is submitted by a correctional facility, the Prior Authorization Team reviews the request along with the inmate’s medical record, current clinical presentation, and treatment provided to date. Then, in collaboration with CHP’s medical director, they determine if off-site care is appropriate. They make this decision by comparing medical requests to national and community standards.

This is a cost effective way to ensure your inmates, our patients, are getting the right level of care while in your custody.

Claims Processing

Our Claims Team understands the nuances of claims payments.

They analyze claims as they come in and confirm the contracted rates for the medical service delivered. They’re able to spot potential discrepancies and duplicate billings on your behalf.

This process removes the burden from you, saving both time and money. Our claims service includes:

• Verification of eligibility/custody
• Review of claims for authorization
• Enforcing contracted rates
• Application of correct coding edits
• Discrepancy review
• Customer service

Data Analytics & Reporting

Data Analytics arms you with the information you need to make informed decisions about your facility.

We gather data to compile information on medical activity, claims payments, and pharmacy authorizations to create a comprehensive reporting package.

Our reporting package provides more than just the basics to help you optimize your processes. They include but are not limited to:

• Clinical authorization and medical request tracking
• Emergency utilization retrospective analysis
• Off-site medical claims expense distribution and trends
• Medication prescribing and usage patterns
• Extensive tracking of internal service delivery
• One-off reporting and special projects support

Account Management

CHP’s Account Managers build a community based medical network to support necessary services for your inmate population. The network establishes reliable and cost effective resources including hospitals, specialists, mobile services, laboratory and ancillary services.

Account Managers:

• Contact community providers when services are needed
• Function as a liason between medical staff and your facility administration
• Maintain provider relationships to enable provider retention
• Deliver continuous support to your facility and its inmate medical needs

Quality Improvement

CHP promotes Continuous Quality Improvement (CQI) processes to improve patient care, clinical management, and to uphold regulatory compliance.

The CQI program monitors and provides tools for improving care. This includes, but is not limited to:

• Documentation of medical and mental health services
• Intoxication and withdrawal treatment processes and documentation
• Chronic care clinic
• Adminstrative processes such as:
  • Checking and using emergency kits
  • Medication storage and administration practices
  • Counts on medications, sharps, tools, etc
• Adverse event reviews

The of CQI is to ensure CHP staff deliver healthcare services that are safe, appropriate and defensible.

Education

Correctional healthcare is unique, and our providers are experts in the industry. CHP has an expanding education program with courses specific to correctional healthcare.

Our Education Department reviews day to day clinical operations in your facility to identify training opportunities with CHP providers. Our providers then create trainings on priority topics.

Trainings include, but are not limited to:

• Suicide prevention and awareness
• Withdrawal assessments
• Emergency preparedness
• Managing hypertension, diabetes, and other chronic illnesses
• Improving mid-level provider procedures such as suturing, splinting, joint injections, administering and reading EKGs and other best practices