CorrectCare

What CorrectCare does

CorrectCare – Integrated Health (CCIH) is a privately held Third Party Administrator (TPA) that provides healthcare claims management services exclusively to correctional facilities in the United States. Founded in 2003 and headquartered in Lexington, Kentucky with a regional office in Sacramento, California, the company serves county jails, state departments of corrections, and California-specific detention facilities. Its service portfolio centers on four modules: (1) Claims Administration, in which experts adjudicate medical claims against Centers for Medicare and Medicaid Services (CMS) guidelines and other standards to reduce non-payable line items; (2) Access to PPO Networks, providing discounted rates through preferred provider, specialist, hospital, ancillary, and ambulance networks; (3) Utilization Management, which uses McKesson InterQual Criteria to assess medical necessity, conduct concurrent inpatient reviews, and channel inmates to network providers; and (4) Client-Specific Services, a modular set of state-tailored offerings including Medi-Cal California inmate claim submission (developed with CCHCS and DHCS), Louisiana Department of Public Safety transition support, and legislated-rates claim repricing.

The technical stack combines CMS-rules-based adjudication with HIPAA-compliant reporting portals (web-based dashboards, on-demand reports, encrypted email delivery, and US Mail) that expose detailed claim analytics by CPT, Diagnosis, and HCPCS code. A dedicated client portal (tpa.correctcare.com) provides self-serve access for existing customers. CorrectCare does not publish an external API and shows no AI/ML features in its current product surface.

The business model is transaction-based per claim plus modest setup fees where applicable (e.g., $650 setup and $20 per claim for Medi-Cal California, including up to 20 providers per county). Go-to-market is sales-led and consultative: direct 'Request a Proposal' outreach supported by trade-show participation with correctional and sheriffs' associations (ACA, NCCHC, AJA, state groups). The customer base is entirely governmental, with documented outcomes ranging from 28% of billed charges being paid by facilities to 50–80% savings on hospital/ER bills, and named wins including Yuma County Jail District (87% per claim savings), Gila County AZ ($375K+ in eight months), and Robertson County TN. Owner-operating, no parent or disclosed institutional backing, sub-50 employees, and self-financed throughout 20+ years of operation.

Name

CorrectCare

Legal name

CorrectCare – Integrated Health

Website

https://correctcare.com

Company type

Private

Founded year

2003

Operating status

Operating

Headcount range

11–50 employees

Short description

CorrectCare – Integrated Health is a private Third Party Administrator that adjudicates medical claims, provides PPO network access, and runs utilization management exclusively for U.S. county jails and state departments of corrections.

Ownership category

akta.pro rank

Product category

Correctional Healthcare Third Party Administration

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Utilization Management (Prior Auth/Medical Necessity) Administration (HLAEALAF)

akta.pro secondary industries

Claims Administration & Payment Integrity (Medical/Dental/Vision) (HLAEALAD), Government Program Administrative Services (Medicare/Medicaid ASO/TPA) (HLAEALAO)

Keywords

• Claims administration services
• Correctional healthcare management
• PPO network access
• Utilization management services
• Third party administration

Headquarters

HQ city

Lexington

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales

Revenue model

1. Claims Adjudication Fees: Per-claim fees for processing and adjudicating medical claims. For Medi-Cal submissions, this includes a $20 per claim fee plus a $650 initial setup fee. For standard claims, fees are based on per-claim processing.
2. Legislated Rates Claims Processing: In states with legislated rates for inmate medical services, CorrectCare reprices claims at legislated rates and charges only for claim processing, eliminating any cost for accessing provider discounts.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

CorrectCare - Integrated Health (CCIH) operates as a Third Party Administrator (TPA) that adjudicates medical claims and manages inmate healthcare services for county jails, state departments of corrections, and other detention facilities nationwide. The company processes inmate medical claims using CMS-based guidelines, provides access to discounted PPO provider networks, and conducts utilization management reviews to assess medical necessity.

Product overview

CorrectCare - Integrated Health (CCIH) is a Third Party Administrator offering a unified corrections-specific platform that combines four core service modules: Claims Administration, PPO Network Access, Utilization Management, and Client-Specific Services. The core platform centers on claims adjudication using CMS guidelines and access to provider discount networks. The Client-Specific Services module extends the platform with specialized offerings including Medi-Cal California claim submission, Louisiana Department of Public Safety transition support, and legislated rates repricing. All services are tailored exclusively for the correctional environment, with facilities reporting savings of 28% or less of billed charges for off-site inmate medical services.

Differentiator

Problem solved

Functional benefit

Products and services

• Claims Administration Adjudicates medical claims submitted by correctional facility clients based on CMS guidelines and industry-standard coding, ensuring appropriate reimbursement for inmate healthcare services rendered by network and out-of-network providers.
• PPO Network Access Provides correctional facility clients with access to discounted PPO provider networks for inmate healthcare services, leveraging negotiated rates to lower the cost of medical claims.
• Utilization Management Conducts utilization reviews using InterQual Criteria and assesses medical necessity for inmate healthcare services, helping correctional facilities control costs and ensure appropriate levels of care.
• Medi-Cal California Claim Submission Submits and processes Medi-Cal claims for California county correctional facilities, capturing available state reimbursement for eligible inmate healthcare services.
• HIPAA-Compliant Reporting Portal Client-specific reporting portal that provides HIPAA-compliant access to claims data, utilization reports, and analytics for correctional facility administrators and their staff.

Quantifiable outcome

• Facilities can pay as little as 28% of billed charges for off-site inmate medical services
• +4 more outcomes

Named customers9 records

Segments3 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

One partnership is on record.

• California Forensic Medical Group (CFMG)minorStrategic or Co-development PartnerIf county clients have existing medical vendors such as CFMG, CorrectCare will work cooperatively with them to assure eligible claims are identified and submitted for Medi-Cal reimbursement. This is a cooperative working relationship rather than a formal partnership.

Scale indicators6 records

Recent moves5 records

Expansion highlights5 records

Direct peers

• Centurion Managed Care: Centurion (a Centene subsidiary) provides managed healthcare services specifically to correctional agencies, including utilization management and claims administration — directly comparable to CorrectCare's TPA model with the added backing of a major managed care insurer.
• CorVel Corporation: CorVel is an established TPA using a PPO network and claims management platform to reduce medical costs for payors — the closest business-model analogue to CorrectCare (transaction-fee claims adjudication plus network discounts), although CorVel focuses on workers' compensation rather than corrections.

Broad incumbents

• MultiPlan: MultiPlan operates one of the largest independent PPO networks in the U.S. and provides cost-containment services analogous to CorrectCare's PPO network access and repricing, albeit across broader healthcare markets and at vastly larger scale.
• Wellpath: Wellpath (formerly Correct Care Solutions and Prison Health Services) is the largest U.S. correctional healthcare company, providing direct medical, mental health, and administrative services across hundreds of facilities — the most direct incumbent comparable to CorrectCare's correctional focus, albeit at much broader scope including clinical care.
• Wexford Health Sources: Wexford Health provides comprehensive correctional healthcare including medical, behavioral, and pharmacy services to state and local correctional agencies — a broad incumbent that competes with CorrectCare for correctional agency budgets across overlapping service lines.
• Corizon Health (now YesCare): Corizon/YesCare is a major correctional healthcare services provider delivering both direct clinical care and administrative services to state DOCs and county facilities — overlaps with CorrectCare's correctional customer base and services stack at a broader, integrated-care level.
• Zelis Healthcare: Zelis provides healthcare cost management including claims adjudication, network management, and payment integrity to health plans and self-funded employers — a broad incumbent whose capabilities overlap directly with CorrectCare's claims adjudication and PPO network access offerings at much larger scale.

Others

• HCA Healthcare (Government / Correctional Services Division): HCA's broader healthcare delivery infrastructure and contract relationships with government payers represent a potential integrator or competitor in correctional medical administration — included as a structural adjacent rather than a direct correctional TPA competitor.

Emerging players

• MAXOR Correctional Healthcare: MAXOR's correctional division provides pharmacy and healthcare services to correctional facilities, intersecting with CorrectCare's utilization management and claims work around pharmacy spend — a partial-overlap peer focused on a specific spend category.
• Public Consulting Group: Public Consulting Group delivers health and human services consulting and program administration to state and local governments, including Medicaid and justice-involved populations — an emerging player with adjacent capability to manage inmate healthcare administrative services for government clients.

Market position

Strengths5 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/correctcare-integrated-health

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about CorrectCare