Claims management in the correctional environment deploys many of the same components common to the competitive insurance environment; yet a non-correctional claims management service is not the most cost-effective approach for your jail. Your typical off-site claims rep has no clue about your financial responsibility and rarely does anyone make a payer determination at the time of encounter. They are simply processing claims and making payments, including the ones that are not your financial responsibility.
At MCHC we determine and verify the correct primary payer on every claim. A single claims manager is assigned to your facility and is the consistent point of contact between the jail and your community providers. Your assigned claims manager will handle your site and not a team of corporate or third-party claims payers. Our Claims Management team works with facilities housing county, per diem, state, and federal inmates. We track all off-site care in real time to determine financial responsibility and ensure providers are notified of appropriate billing at the time of encounter. Every off-site care event is immediately reviewed as to inmate type and financial responsibility. This further ensures proper authorization for reimbursement is obtained from non-county agencies. For claims that are the financial responsibility of our clients, MCHC pays within 10-days of a dropped claim. That is unheard of in the industry.
MCHC works diligently to ensure community providers are paid timely and have a personal contact for timely follow up. We will not let your Sheriff, Warden, or County Commissioners get blindsided by a provider claiming the jail never pays its bills. You will not get this level of personalized service with any other claims company.