Advanced Correctional Healthcare Management

Prior Authorization And Utilization Management

The overall utilization services CHP provides to its clients contribute to effective and efficient care for offenders. To assure appropriate management and utilization of healthcare, Correctional Health Partners uses Milliman Care Guidelines in conjunction with the criteria, guidelines, and benefits established by each state corrections system. We also have our Clinical Guidelines Committee which annually evaluates all guidelines and provides recommendations and revisions to the current standards.

Our Prior Authorization Department reviews requests of services on behalf of our contracted clients. We make sure the offender is receiving the appropriate care, at the appropriate time, and in the appropriate setting. This ensures the healthcare dollars are being used in the most efficient way to optimize clinical outcomes. Physicians at the correctional facilities submit requests for specialty physician referrals directly to CHP, and we assist them by directing care to contracted network providers to maintain quality, cost-effective care for all their patients.