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At Jai Medical Systems, keeping our providers informed is our top priority.
A Message from the Director of Provider Relations
Dear Provider,
Thank you for being a valued participating provider with Jai Medical Systems! I am reaching out because we need your help! On an annual basis, the Maryland Department of Health conducts a Network Adequacy Validation (NAV) analysis of our provider network. This analysis is conducted through an independent telephone survey in which a sample of the providers listed in our Provider Directory will be called to validate that the information listed in our Provider Directory for you or your practice is correct.
Your participation in this survey is important and will help us improve the information that we share with both providers and members.
Ways to Help:
- Network Participation Awareness. Please ensure that your staff, especially frontline staff, are aware of your participation status with Jai Medical Systems. If your office would like a Jai Medical Systems Participating Provider sticker, please contact our Provider Relations Department today at 1-888-JAI-1999.
- Accurate Directory Listings. Please ensure that your directory listing is up-to-date. If there are any changes to your practice such as address, phone number, or office hours, please let us know! You can submit changes to your provider directory listing online at www.jaimedicalsystems.com, or by contacting us at providerrelations@jaimedical.com.
We appreciate your assistance with this important matter. If you have any questions, please do not hesitate to contact me at 1-888-JAI-1999.
Exciting News: Health Equity Accreditation
Jai Medical Systems is excited to share that we recently obtained Health Equity Accreditation from the National Committee for Quality Assurance (NCQA). This Accreditation from NCQA recognizes our commitment to ensuring that we are providing appropriate services based on the diverse culture and languages of our members. NCQA is a private, non-profit organization dedicated to improving health care quality.
SURVEY: Specialty Care Access
Ensuring our members have access to specialty care services in a timely manner is very important to Jai Medical Systems. In an effort to assist us with connecting members in need of specialty care quickly, we would appreciate your feedback regarding appointment availability of your specialty care practice by completing our survey regarding your practice’s appointment availability. Our goal is to be able to share your survey feedback with referring network providers, including our Primary Care Provider network, so that they can quickly link members to needed care.
Primary Care Corner:
Important Updates and Reminders
Preventative Healthcare Panel
During the month of June, our Quality Assurance Department sent a special mailing to our network Primary Care Providers, which included a list of members who may be due for preventative healthcare services. If you did not receive a copy of this special mailing, or would like this information electronically, please contact us at providerrelations@jaimedical.com, so that we may send this information to you.
Referrals and Prior Authorization
Jai Medical Systems accepts both the Maryland Uniform Consultation Referral Form and our Jai Medical Systems Referral Form. Please ensure that all completed referrals issued for our members are faxed to our referral fax line at 1-866-381-7200. For services that require prior authorization, please complete a prior authorization form, which can be found on our website at: https://www.jaimedicalsystems.com/providers/provider-resources/.
ePREP and NPI Uncollapsing
All providers rendering care to Medicaid beneficiaries must enroll and remain in an active status with Maryland Medicaid through their electronic Provider Revalidation and Enrollment Portal (ePREP). Failure to properly enroll or remain in an active status with Maryland Medicaid’s ePREP system may result in claim denials. To check your current ePREP status, please visit https://eprep.health.maryland.gov/.
Further, if you have recently participated in the NPI Uncollapsing Initiative with Maryland Medicaid, please keep Jai Medical Systems informed of any changes with regard to your billing practices and billing information such as your Tax Identification Number (TIN), Billing NPI and Address, as well as any NPI Specific Location information. Please be sure to send any changes to your billing information to our attention as soon as possible to ensure that there are no delays in our processing of your claims.
Formulary Change Notice
Effective 7/1/2025, Jai Medical Systems has removed Stelara from its formulary, and added Yesintek, a Stelara biosimilar, to our formulary. In addition, effective 7/1/2025, Jai Medical Systems has also made the following formulary changes:
- Added Eligard to the formulary with a Prior Authorization
- Removed Skyrizi IV
For the most up-to-date information regarding our formulary and other important pharmacy benefit information, please visit us online at https://www.jaimedicalsystems.com/ providers/pharmacy.
New: Continuation of Therapy Form for High Cost and Specialty Drugs
Jai Medical Systems has implemented a new Continuation of Therapy Form for certain High Cost and Specialty Medications. This new form is available on our website at https://jaimedicalsystems.com/providers/pharmacy/. Currently, we are working with our PBM to outreach to prescribers who may need to complete this new form for continuation of current approved therapies.