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 2018 – VOLUME LXIV

Thanks to you, Jai Medical Systems is the highest performing MCO on the 2018 HealthChoice Report Card.

Jai Medical Systems would like to thank all of our participating providers for their support and their excellent delivery of healthcare services to our members. The HealthChoice Report Card above compares MCOs in several key areas related to patient care. Thanks to you, Jai Medical Systems earned 17 out of 18 stars. No other health plan came close to this performance.


Secret Shopper Program 2018

The State of Maryland has engaged a vendor to conduct phone call surveys to determine the accuracy of the provider directory listings of the participating providers in our network. To ensure that we are providing our members accurate information about the providers in our network, we need your help!

  1. Please ensure that ALL of your staff members are aware that you participate with Jai Medical Systems! If you would like a Jai Medical Systems Participating Provider sticker, please contact our Provider Relations Department today at 1-888-JAI-1999.
  2. Please ensure that you keep us informed of the most up-to-date demographic information regarding you and your practice. If there are any updates to your practice, including a change of your hours of operation, phone number, fax number, address, etc., please let us know as soon as possible! By informing us of changes as soon as they occur, we can ensure that our printed and online provider directories reflect the most accurate information about your practice.

In the near future, you will receive a Provider Demographic Verification Letter. Please review this letter carefully to ensure that the information listed is accurate. For your convenience, provider demographic changes may be made online at any time at www.jaimedicalsystems.com.


ALERT: Your patients may be at risk for losing their health insurance!

Jai Medical Systems has been notified that Medicaid recipients with invalid mailing addresses will be at risk for losing their health insurance benefits. To prevent this from occurring, we ask that you please educate your patients, our members, about the importance of having that the most up-to-date demographic information on file with the Maryland Health Connection (MHC). Members may update their information with the MHC by calling1-855-642-8572 or online at www.marylandhealthconnection.gov. Members also have the option to get in-person help from a connector entity, local health department, or local department of social services. Lastly, members have the option to contact our Customer Service Department at 1-888-JAI- 1999 for assistance.


Online Access to MCO Formularies and Formulary Updates

Effective February 1, 2018, the Maryland Department of Health has transitioned to a new online formulary management resource called Formulary Navigator. The Formulary Navigator will provide prescribers information related to each MCOs formulary. To view our formulary using formulary navigator, please visit: https://client.formularynavigator.com/

In February 2018, Maryland Medicaid updated its Hepatitis C Treatment Criteria. For more information on the Hepatitis C Criteria updates, please visit the Maryland Department of Health website at https://health.maryland.gov/.

*Reminder: Basaglar was added to our formulary December 2017


Contraceptive Coverage Changes

Effective July 1, 2018, Jai Medical Systems will allow the single dispensing of up to a twelve-month supply of contraceptive medication when ordered by a qualified practitioner. If you have any questions related to this change, please visit our website.


New Benefit: Audiology Services for Children and Adults

Effective July 1, 2018, Jai Medical Systems will cover medically necessary audiology services, hearing aids, cochlear implants, and auditory osseointegrated devices for all members regardless of age. For more information, please contact our Provider Relations Department at 1-888-524-1999.


Provider and Member Satisfaction Survey Results

Effective July 1, 2018, Jai Medical Systems will cover medically necessary audiology services, hearing aids, cochlear implants, and auditory osseointegrated devices for all members regardless of age. For more information, please contact our Provider Relations Department at 1-888-524-1999.

Provider Survey Results

In December 2017, providers were requested to complete the Jai Medical Systems’ Internal Provider Satisfaction Survey. Results indicated that 100% of providers surveyed reported that they would recommend provider participation with Jai Medical Systems. Providers also indicated a high satisfaction rate with credentialing, our Customer Service Department, Provider Relations and Utilization Management staff, and Quality Assurance initiatives and programs. An area identified for improvement is expanding the Jai Medical Systems provider network. Many providers indicated that adding more Pain Management and Dermatology providers would be most helpful, as well as other specialties. The Provider Relations Department is actively working on expanding our provider network to include additional providers throughout the state. We appreciate your feedback! If you have any additional suggestions to help us improve the services that we offer, please contact the Provider Relations Department at 1-888-JAI-1999.

Member Survey Results

The 2017 Internal Member Satisfaction surveys were distributed to the HealthChoice members with the 2017 Fall member newsletter. Surveys were collected and analyzed at the end of 2017 and resulted in an overall satisfaction rating of 83.8% from our members. Two areas identified for improvement were the Amount of Time Spent Waiting to see the Doctor (with and without an appointment) and Amount of Time Doctor Spent With You During Your Visit. The areas that our members ranked us highly in were Willingness of Doctor to Explain Medical Problems and Treatment, Doctor’s Explanation of Prescription Medications, and Doctor’s Attention Given to What You Had to Say.


Visit Us Online

There are many online services available for our members and providers. Many of the resources listed in the chart on the left are available on our website at www.jaimedicalsystems.com.
If you prefer, all of this information is also available in print and by telephone. You may request this information by calling Jai Medical Systems at 1-888-JAI-1999.


Updates and Reminders:
  • Provider Portal: Participating providers are encouraged to utilize our Provider Portal to check member eligibility, claim status, appeal status, and much more. To begin using our Provider Portal, please visit our website: www.jaimedicalsystems.com
  • 24 Hour Nurse Advice Line: Please inform members about our 24 Hour Nurse Advice Line. To access our 24 Hour Nurse Advice Line, members should call 1-844-259-8613.
  • Electronic Claims Submission: To submit claims electronically, please register by visiting ClaimsNet website at www.claimsnet.com/jai. Prior to submitting your claims, please fax the appropriate authorization Attn: Authorizations, Fax Number 1-866-381-7200.Prior to submitting your claims, please fax the appropriate referral to Attn: Referrals, Fax Number 1-866-381-7200.
  • Case Management & Disease Management Programs: Jai Medical Systems offers Case Management and Disease Management programs to ensure that our members can live life well. For more information about these programs or to refer a patient of yours who is a Jai Medical Systems member, please contact our Customer Service Department at 1-888-JAI-1999.
  • MD Quitline: All of our providers are encouraged to connect tobacco-using patients directly to the Maryland Quitline. You may contact the Maryland Quitline directly at 1-800-Quit-Now.