ADMINISTRATIVE Services

Your Potential is Our Passion

JMS objectives are to resolve common challenges most insurance Payors experience prior to and during the in-loading of claims into our client's adjudication systems. Re-routing paper, image, or EDI claims to a JMS facility allows your company to free up key technical and administrative resources to perform other tasks.

Front-end claim conversion solutions assist with resolving member and provider data issues within your systems that typically prevents your claims data from auto-adjudicating. Using JMS data maintenance and matching services ultimately increases auto-adjudication rates that reduce overall claim administrative costs.

Mail Room Services & Fulfillment

Various options are available for delivery of paper claim and other paper documents to a JMS process center. Those clients local to our regional processing centers have access to couriers for pick-up and return of paper documents, or for remote clients, claims are re-routed to a dedicated post office box and are received through a local U.S. mail facility. For clients that prefer to keep documents in-house, scanning equipment is installed to support conversions to image, and then transferred to a secured JMS server.

Our mailroom services support client based sorting and batching requirements, and scanned into an electronic image format.

Scanning & Imaging

Documents are scanned with high speed commercial scanners into a high quality electronic format to meet claim retrieval requirements.

Data Entry

JMS operators perform direct data entry through a secured connection into the client’s system. Minimal setup and implementation time allows JMS to relieve the pressures for entering claim information into their adjudication software quickly.

Data Conversion

The most efficient method for entering claims into most adjudication systems is through EDI interfaces that provide for a quick method for in-loading claims. JMS performs data capture of claim information through its proprietary systems that incorporate data verification processes providing the highest data quality in the industry.

OCR (Optical Character Recognition)

Specialized software systems are used to automatically identify and capture both printed and handwritten data. Forms claim data can be extracted electronically through our software systems and manually verified to guarantee accuracy.

Document Image Hosting & Retrieval

Electronic images are indexed and securely stored for a pre-determined retention period on JMS secured servers for quick and simple retrieval by authorized users. JMS also offers customized workflows to support assignment, distribution, and tracking of documents within your organization.

Storage, Retrieval, & Shredding

Paper claims and documents are stored for a pre-determined retention period in a JMS secured facility. Paper copies or originals are available upon request and can be distributed via U.S. mail, secured email, or secured fax. Once retention periods expire, JMS performs HIPAA compliant shredding of all paper documents.

Member & Provider Data Validation

Using an electronic extract of our clients Provider and Member Eligibility data, JMS improves claim matching edits that occur during the EDI in-load process to support the auto-adjudication process.

Claims Re-Pricing / Network Routing

PPO re-pricing services is provided through systematic or manual lookups. JMS supports EDI Routing through its Claim Exchange product or automated Fee Schedule matching. Our Claim Exchange system converts claim data to-and-from any format for distribution to your networks and logs all transactions to support your reporting and claim review requirements.

Provider & Member Maintenance

When changes occur to provider or member data JMS operators securely login to your adjudication software and perform manual updates, such as NPI data that supports your HIPAA compliance efforts.