Professional Solutions

Once you make the decision to implement a JMS solution, we assign Subject Matter Experts and Project Managers knowledgeable in all aspects of the claim administrative process, to execute and guide your company throughout the implementation and ongoing production process.

Health Plan Benefit Building

Experienced Plan Builders configure your adjudication systems to maximize claim payment automation methods that ultimately improve claim payment accuracy and reduce overall claim administrative costs.

Health Plan Benefit Testing

After building new or modifying existing plans, or after vendor software upgrades, our Plan Benefit Testing Teams input and verify extensive claim scenarios. This service comes with a standardized suite of claims, which can be tailored to support unique plan type or benefit features.

Claim Auditing

Maximize claim accuracy by inserting JMS resources into your claim payment work-flow and recoup over-payments before paying claims, and identify build logic issues or prevent incorrect payments before releasing claims.

FSA, HRA, HSA and DCA Claims Examining

Stabilize seasonal claim volume spikes related to cafeteria plan claims by implementing experienced JMS resources to process manual claims or assist with debit card substantiation. Our teams are knowledgeable of all intricacies of plans and IRS guidelines.

1099 Solution

JMS takes a proactive approach quarterly to ease your 1099 process, validating your data with the IRS and sending out W9’s to invalid providers with all correspondence managed by JMS. We can help those that cannot extract your data in the 1099 IRS format. Not only that, but our team can update your file with valid information in time to print and mail in January, as well as file electronically with the IRS. JMS will also handle all CP2100 requirements should you receive a penalty notice.

Health Plan Benefit Auditing

Experienced Plan Auditors review and compare existing benefit logic in the platform against the Summary Plan Document, improving payment accuracy.

Claim Examining

Reduce claim inventory requirements and claim adjudication turn-around-time. JMS has trained resources that can quickly adapt to your business requirements and as fluctuations occur, we can ramp-up or ramp-down on demand. Our services are contractually guaranteed to meet and likely exceed your service level objectives.

Eligibility, Enrollments, & Cobra

JMS provides trained resources to handle all your data entry needs for adding, modifying, or terminating Members within your system. Our Teams have experience with multiple source documents and can also assist with processing COBRA packets and enrollments.

Call Center Management Services

Reduce abandonment rates and improve answer times by adding experienced Call Center resources for both Provider or Member inquiries. Your company will immediately begin to experience improved service levels that will have a positive impact on your Client’s Customer satisfaction. Our Call Center implementation process supports a seamless and quick transition to acquiring qualified resources to support your service level objectives.

Conclusion

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