Provider News & Notices

At Jai Medical Systems, keeping our providers informed is our top priority.

At Jai Medical Systems, keeping our providers informed is our top priority.

Please review the information below for our newsletters, latest healthcare updates, and special announcements.

Jai Medical Systems Managed Care Organization, Inc. Provider Newsletter

Summer 2021 – VOLUME LXIX

Thank you!

Happy Summer! We hope you are doing well and that your summer is off to a good start. Jai Medical Systems would like to take this opportunity to thank all of our providers for the care that they have provided to our members throughout the COVID-19 Pandemic.Your hard work and dedication are greatly appreciated. Thank you! In this newsletter, we will cover a variety of topics that you may find useful in your daily practice and in caring for our members. The most important topic covered is related to COVID-19Vaccinations and vaccine availability.

COVID-19 Vaccination Efforts

Maryland continues to make strides in its COVID-19 vaccination efforts. These vaccination efforts are having a meaningful impact on the COVID-19 pandemic here in Maryland. In fact, in June 2021, Maryland has experienced COVID-19 testing positivity rates below 1% for the first time. In addition, hospitalization rates are falling as more and more Marylanders receive the COVID-19 Vaccine.

Unfortunately, Maryland Medicaid vaccination rates lag behind the average vaccination rate for Maryland. Please help us get the word out and ensure that all Medicaid recipients, ages 12 and up, are vaccinated against COVID-19.

Further, please be aware that the current mass vaccination sites will not remain open indefinitely. We do anticipate that some of the mass vaccination sites will close as demand and utilization at mass vaccination sites dwindles. For this reason, it is critically important that as mass vaccination sites stand down; primary care providers stand up to help with vaccination efforts and fill the void left when mass vaccination sites are closed.


How to Receive the COVID 19 Vaccine for your practice

At this time, COVID 19 vaccine supply is readily available. As indicated in our prior Newsletters, providers interested in receiving COVID-19 vaccine supply must register with Immunet. For more information about Immunet registration and to register, please visit www.mdimmunet.org. Please be aware that once approved by Immunet, providers will need to order their vaccine supply directly from Immunet. This includes directly ordering second doses as applicable and necessary directly from Immunet.

If you require any assistance with registering with Immunet, please do not hesitate to contact our Provider Relations Department.


COVID-19 Vaccine Storage, Safe Handling, and Administration

In order to ensure positive outcomes with vaccination efforts; it is important to adhere to the Centers for Disease Control (CDC) guidance related to the COVID-19 vaccines. Please visit the CDC COVID-19 Vaccine web page and resources available at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html. In addition to having the most up-to-date information related to safe storage and handling of COVID-19 vaccinations; there are helpful Modules available regarding many aspects of the COVID-19 vaccines.


Have you enrolled with ePREP?

Maryland Medicaid requires all providers rendering care to Medicaid beneficiaries enroll with Medicaid’s new electronic Provider Revalidation and Enrollment Portal (ePREP). Maryland’s ePREP system is Medicaid’s one stop shop for provider enrollment, re-enrollment, revalidation, information updates and demographic changes. According to the Maryland Department of Health, all providers submitting claims for HealthChoice members must enroll with ePREP as soon as possible.

Failure to enroll in Maryland Medicaid’s ePREP system and be an active provider will result in claims denials.

To enroll or revalidate with Maryland Medicaid today, please visit the ePREP website at www.ePREP.health.maryland.gov or contact the ePREP call center at 1.844.463.7768.

If you have any questions about the ePREP enrollment process, please feel free to contact our Provider Relations Department today at 1-888-JAI-1999 or the Maryland Department of Health at MDProviderRelations@automatedhealth.com.


Provider Credentialing & Contact Information

In order to join and maintain participation status with the Jai Medical Systems network, each provider must comply with our Credentialing and Recredentialing requirements. We kindly request that all providers provide us with the most up-to-date information about their organization. This information will ensure that we provide the most accurate information to our members and providers, and to ensure appropriate claims payment.

Please also ensure that all staff in your office are aware of their participation status with Jai Medical Systems.

We do not want members turned away because of a miscommunication! Please feel free to call the Provider Relations Department at 1-888-JAI-1999 with any questions.


Claim Submission Guidelines

To ensure that your claims are processed quickly and accurately, please be sure to follow these simple guidelines regarding billing practices, referrals, and authorizations. When submitting the following type of claim, please ensure that you are following Jai Medical Systems’ Billing Instructions in addition to the listed items below:

  • Timely submit all claims, either electronically or on paper, within 180 days of the date of service.
  • Attach or Fax one copy of a valid completely filled out, legibly written referral, outpatient authorization, or inpatient authorization, where applicable, to Jai Medical Systems’ Claims Processing Center (fax number 1-866-381-7200) prior to claim submission.
  • Include the appropriate authorization number that is valid for the claim being billed. Authorizations include referrals, outpatient authorization, or inpatient authorization to be billed in the appropriate field. This field is located in block 23 for the CMS1500 form and block 63 for the UB-04.
  • Indicate or attach a copy of the member’s primary insurance Explanation of Payment (EOP) or Remittance advice any information regarding the member’s primary insurance and any payment made from the third party payor (TPP), if applicable.

Updates and Reminders:
  • Electronic Claims Submission: To submit claims electronically, providers must register with ClaimsNet website at www.claimsnet.com/jai. When applicable, prior to submitting your claims, please fax the appropriate authorization or referral to Fax Number: 1-866-381-7200.
  • Provider Portal: Participating providers are encouraged to utilize our Provider Portal to inquire about member eligibility, claim status, appeal status, and much more. To begin using our Provider Portal, please visit our website at www.jaimedicalsystems.com
  • 24 Hour Nurse Advice Line: Please inform members about our 24 Hour Nurse Advice Line. To access, members should call 1-844-259-8613.
  • Did you know? Audio-Only Primary Care Telehealth visits for Established patients, previously allowed under the Public Health Emergency, will continue to be covered through June 2023. Audio- Only visits will also remain covered for substance abuse and/or mental health services as established under the Preserve Telehealth Act of 2021
  • E-Blast! At Jai Medical Systems, we are continually striving to reduce our impact on the environment and improve provider satisfaction. Providers are automatically enrolled to receive emails from Jai Medical Systems. If you would like to opt out, please select the unsubscribe button at the bottom of the email. To sign-up today, please visit our website at www.jaimedicalsystems.com
  • Prior Authorization Jai Medical Systems requires a prior authorization (PA) be obtained for certain services and procedures. Prior to submission of a PA request, approval for the applicable procedure shouldbe received from the Primary Care Provider. For a listing of procedures and services requiring a PA, please visit our website. If you do not see a procedure or service listed, or would like to see if a PA may be required for a particular service or procedure, please contact our Utilization Management Department at 1-888-JAI-1999

It is against the law to commit fraud or abuse!

Examples of fraud or abuse:

  • Anyone who forges a physician’s signature on a prescription medication or uses a physician’s name to call a false prescription in to the pharmacy.
  • Anyone who lies about having lost prescription medication.
  • Anyone who gets prescription medication when they are not ill.
  • Someone who used or is currently using a medical ID card that does not belong to them.
  • Any member who excessively overutilizes emergency services when not necessary.
  • A Provider who bills for services not rendered.

Individuals suspected of committing fraud and/or abuse by Jai Medical Systems Managed CareOrganization, Inc. will be submitted to the Maryland Department of Health– Office of Inspector General (DHMH-OIG) for further investigation.

How Do I Stop Fraud and Abuse?
We welcome and encourage you to report anything suspicious you may have seen. You can report suspected fraud and/or abuse without fear of reprisal.

To Report Fraud and Abuse
You can call the Fraud and Abuse Compliance Officer at 1-888-JAI-1999 or write to:
Fraud and Abuse Compliance Officer
Jai Medical Systems
301 International Circle
Hunt Valley, MD 21030


Visit Us Online

There are many services available online to both our members and providers. The resources listed in the chart to the right are available on our provider portal or on our website at www.jaimedicalsystems.com.

If you prefer, all of this information is also available in print and/or by telephone. You may request this information by calling the Provider Relations Department at today 1-888-JAI-1999.


Contact Us
Providerrelations@jaimedical.com
301 International Circle Hunt Valley, MD 21030
Phone: 1-888-JAI-1999
Hours of Operation: Monday – Friday
9am-6pm