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 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 from auto-adjudicating. Using JMS data maintenance and matching services ultimately increases auto-adjudication rates that reduce overall claim administration costs.

Mail Room Services & Fulfillment

Various options are available for delivery of paper claim and other paper documents to a JMS process center. Clients local to our Regional processing centers have access to couriers for pick-up and return of paper documents. 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 mail room services support Client based sorting and batching requirements, and the documents can be 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.

Online Data Entry

JMS Operators perform direct data entry through a secured online connection into the Client’s system. Minimal setup and implementation time allows JMS to relieve the performance pressures of the Client entering claim information into their adjudication software quickly.

Offline Data Conversion

Gain efficiencies through paper claim conversion to EDI 837 formats. JMS performs data capture of claim information through its proven proprietary systems and methodology that incorporates multi-level data verification, 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. 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 predetermined retention period on JMS secured servers for quick and simple retrieval by authorized users.

Storage, Retrieval, & Shredding

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

Provider & Member Maintenance and Matching

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. JMS Teams can help you maintain a more organized and accurate Provider and Member table through manual or automated loading procedures.

Network Claims Re-Pricing

PPO Re-pricing services are provided through systematic or manual lookups. JMS supports EDI Routing through its Claim Exchange product (Also Known As: Automated Fee Schedule Matching). Our Claim Exchange system converts claim data to-and-from any format for distribution and logs all transactions to support your reporting and claim review requirements.