The South Dakota Association of County Commissioners (SDACC) is proud to partner with Correctional Risk Services (CRS) to offer two new programs to help South Dakota counties contain the costs of medical care for county inmates.
Inmate Medical Claims Review Service: CRS will perform claims administration management for all county inmates housed in a county jail. Claims administration management will include:
1. Determine if the medical treatment was actually delivered.
2. Determine if the medical treatment was medically necessary.
3. Provide hospital and physician discounts, where available, through our PPO network.
4. Negotiate ‘quick pay’ discounts from providers whenever possible.
5. Prepare checks to be sent to hospitals, physicians, and other medical care providers.
6. Furnish explanations of payment.
7. Provide detailed claims reports.
8. Furnish Sheriff Department personnel with Inmate Provider Claim Cards.
9. CRS retains a percentage of what they save on the billing. If there are no savings – there are no costs to the county.
Inmate Medical Budget Protector: CRS will provide inmate excess medical insurance for county inmates. The policy will include the Claims Administration Management and the following:
1. A $10,000 deductible per county inmate, per contract year.
2. A policy limit up to $250,000 (less deductible) per inmate, per contract year.
3. Covered charges include:
a. Inpatient hospitalization
b. Outpatient surgical charges
c. Emergency room charges – if followed by a hospital admission
d. Physicians’ & surgeons’ fees
e. Anesthesiologists & radiologists charges,
f. Nurses charges
g. Diagnostic x-ray & laboratory services
h. Dressings, drugs, & medicines dispensed in a hospital or outpatient facility
i. Medical conditions such as cancer, heart, kidney, diabetes are covered illnesses
j. Accidental injuries, fights, self-inflicted injuries, and attempted suicide.
4. No pre-existing medical condition limitations after coverage has been in effect for 72 hours.
NOTE: This is a summary of the plan details. Please call SDACC at (605) 224-4554 for specific details.