TPA Company’s business continued to grow with new groups, and they were continuously confronted with the challenges of hiring and training new employees quickly to keeping up with deadlines and turn-around service levels. Recognizing the benefits of their existing relationship with JMS managing our mailroom and paper claim conversion, TPA Company made the decision to expand the relationship by contracting with JMS in 2011 to supply claim examiner resources to remotely adjudicate claims directly within Healthpac.
JMS was able to assist with their decision by providing dedicated claim examining resources that had previous Healthpac knowledge, and they were fully trained with the client’s group plans and business rules and ready for production within 3 weeks.
TPA Company SME’s (Subject Matter Experts) provided training that consisted of 2 Web Based meetings per week for 3 weeks for a total of 12 hours of client training, in addition to JMS‘s internal training review. Low production volume was initially implemented for several weeks so that TPA Company could perform 100% audit of their claims and to confirm that the process was working and services levels were meeting or exceeding expectations and full production was approved.