Claim Examining

It’s almost guaranteed, sometime this year you’ll have a backlog of claims to deal with. Odds are it will be due to one of the following reasons:

  • You won new business. – Great news, but volume increases can cause a backlog of claims.
  • A system upgrade or transition to a new system. – Needed, but business goes on while you changeover.
  • Resource allocation. – You just can’t find enough qualified people to do the work.
  • Low auto adjudication rates.

 

Thankfully, we have nearly 20 years of experience with this. Lean on us to alleviate any of these common Claim Examining issues:

  • Fluctuating Volumes
  • Unexpected Backlogs
  • System Conversion
  • Staff Turnover
  • Find, Hire, & Train
  • Increased Overhead
  • Health & Benefit Costs
  • Limited Space
  • Slim Margins
Not only that, but we offer a lot of other Professional, Administrative and Technical solutions.

Still not sure?

Take a look at our Case Studies.

You can rely on us.

They all have.

"The Keenan Employee Benefits TPA has been a JMS believer since 2010, coming to our rescue during our system conversion and providing us with the rapid and quality support we needed and could trust. Continuing now for ten years, we have built on a great relationship taking advantage of more and more JMS resources. We’re getting the job done and saving time and money. The JMS team is great – true partners!"

Keenan Employee Benefits TPA

Walter T. Pregizer

Vice President

“CCP currently processes over 100,000 claims per month. While we are presently receiving 84% of our claims electronically, in order to achieve excellence in our claims shop, we needed to partner with an outside vendor to assist with our paper to EDI claim conversions. JMS & Associates was selected as the top-ranking vendor of choice. Since our partnership began in 2009, our experience at each phase of our efforts was superior. Their facilitation, due diligence and competence is why our relationship remains in full standing today. The value of services provided by JMS is immeasurable.”

Community Care Plan

Tracy Harswick, CPC

Vice President, Payment Operations and Project Management

“JMS has been a partner of our Third Party Administration firm for ten plus years with us using their repricing and EDI functionalities as a service. Our firm recently replaced our proprietary claims adjudication platform, moving to a market leading SAAS solution and we quickly found ourselves in need of a consulting partner to help navigate all that goes along with a change of such magnitude. JMS has stepped up and assisted every step of the way. We have since grown our integrated services with JMS utilizing additional resources from across their service offerings and looking back, I wouldn’t have done it any other way. Great group of business professionals that have delivered time and time again. JMS will continue to be a part of the story of our firm's successes for a long time to come!”

Jason Yount

Alternative Insurance Resources, Inc.

President

“ACS Benefit Services, LLC has been working with JMS for nine years. My team works with JMS in relation to the paper claims they translate to 837 EDI claim files. Anytime we have seen an issue with that translation they are very quick to get on a conference call with the necessary parties to discuss the issue and resolve it. They also perform indexing functions of the forms we scan internally. Teaming up with JMS to perform this function has saved my team a great deal of man hours and allowed us to utilize existing staff in other areas of responsibility. I have had the pleasure of working with the several of the higher level management team including the President, CEO, VP of Operations and VP of Sales. They are all wonderful to work with and treat me as if I am as important as our senior level management. That is wonderful customer service!”

ACS Benefit Services, LLC

Mandi Burkhart

Assistant Vice President, Administration

“Taylor Benefit Resource started using JMS in 2014 as a Clearinghouse. After much success we used them to help us with Data Conversion and Plan Building. We have had tremendous growth over the past year and they have been very instrumental in helping us get through the addition of new groups. They built several plans for us in a very short time frame. While building these plans they helped us with some issues we had been having since the conversion from ICD9 to ICD10. We have been more than pleased with their service and will continue a relationship with JMS as we continue to grow and add more business.”

Carol Hopper

Mandi Burkhart

Claims Manager

"has partnered with JMS for over five years. This partnership is invaluable to us as an organization. We have evolved and grown together during this relationship beyond measure. JMS does more than support BPA’s claim processing, provider maintenance, 1099 handling, IT functions, and other areas; JMS is a strengthened vertebrae in the backbone of BPA relative to those areas and, fused with BPA’s internal experts, aligns our corporate structure and success. Most recently, we have worked hand in hand to develop proprietary customized tools to harness, document, validate, and track each component inside our cloud based Information Technology department. This project allowed us to not only develop sophisticated tracking for inbound and outbound files but to create programming that supports those files and resulted in visible, tangible platforms for BPA Executives to constantly have the pulse on the inner workings of BPA. Through BPA’s vision and direction, JMS made the HUB of our organization sync and fuse with all areas of BPA. BPA views JMS as an extension of our organization and a family within the BPA family"

Mary Markle Bender

Benefit Plan Administrators, Inc.

Systems Manager

"JMS has been a partner of our Third Party Administration firm for ten plus years with us using their repricing and EDI functionalities as a service. Our firm recently replaced our proprietary claims adjudication platform, moving to a market leading SAAS solution and we quickly found ourselves in need of a consulting partner to help navigate all that goes along with a change of such magnitude. JMS has stepped up and assisted every step of the way. We have since grown our integrated services with JMS utilizing additional resources from across their service offerings and looking back, I wouldn’t have done it any other way. Great group of business professionals that have delivered time and time again. JMS will continue to be a part of the story of our firm's successes for a long time to come! "

Benefit Plan Administrators, Inc.

Alternative Insurance Resources, Inc

Jason Yount, President

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