Administrative Solutions

At JMS and Associates, we want to resolve common challenges that 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 will allow you 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.

By using JMS data maintenance and matching services, you will ultimately increase auto-adjudication rates that result in reduced overall claim administration costs.

Mail Room Services & Fulfillment

Various options are available for delivery of paper claims and other paper documents to a JMS process center. If you’re local to our Regional processing centers, you will have access to couriers for pick-up and return of paper documents. If you’re remote, then claims are re-routed to a dedicated post office box and received through a local U.S. mail facility. If you prefer to keep documents in-house, your team will send the scanned images and they will then be transferred to a secured JMS server.

Our mail room services support Client based sorting and batching requirements, and the documents will be scanned into an electronic image format.

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.

Network Claims Re-Pricing

PPO Re-pricing services are provided through systematic or manual lookups. JMS supports EDI Routing through its Claim Exchange product (AKA 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.

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.

Online Data Entry

JMS Operators perform direct data entry through a secured online connection into your system. Minimal setup and implementation time allows JMS to relieve the performance pressures of you entering claim, provider or member information into your adjudication software quickly.

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 and electronic documents.

Scanning & Imaging

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

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.

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.


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