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.

Spring 2022 Volume LXXIII

A Message from the Director of Provider Relations

Dear Provider,

Thank you for your continued support and the care that you have provided to our members during the COVID-19 pandemic. We especially appreciate your efforts in educating our members about the importance of COVID-19 vaccination. If you have a member who is interested in receiving the COVID-19 vaccine and your office does not administer the vaccine, please refer the member to a participating COVID-19 vaccine provider by visiting: https: www.vaccines.gov.

For our members who may test positive for COVID-19, please consider prescribing a COVID-19 antiviral oral regimen, such as Paxlovid, as appropriate. Paxlovid is available at certain pharmacies and local health clinics across the state. Paxlovid has been shown to significantly reduce the risk of hospitalization for adults who have recently tested positive for the virus. For more information on Paxlovid and the locator tool, please visit  covid-19-therapeutics-locator-dhhs.hub.arcgis.com.

Regards,
Hennrietta Dodoo
Director of Provider Relations


Provider Directory Accuracy Audit

To ensure that we are providing our members accurate information about the providers in our network, we need your help! 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. Please help us do well on this audit by taking the following steps:

  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 let us know.
  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, or email address, 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 recetve a Provider Demographic Verification Letter. Please review this letter carefully to ensure that the information listed is accurate. For your convenience, demographic changes may be made online at any time at www.jaimedicalsystems.com. You can also reach out to our Provider Relations Department at 1-888-JAI-1999 or via e-mail at providerrelations@jaimedical.com to report any updates.


Home Visiting Services Program

Effective January 13, 2022, Maryland Medicaid has expanded its coverage of evidence-based home visiting services (HVS) to all Medicaid participants. Home visiting services associated with one of two evidence-based models, Health Families America (HFA) or Nurse-Family Partnership (NFP), will provide supportive services for pregnant individuals during pregnancy and childbirth; as well as provide support for parents and children during the postpartum period.

Prior authorization or a referral is not required for HVS through a managed care organization’s provider network. Providers can refer eligible individuals to participating HVS providers. HVS providers who have received either (1) a designation of fully accredited by the HFA National Program Office or (2) a designation of fidelity by the NFP National Program Office are eligible to enroll as a “HVS provider” type through electronic Provider Revalidation and Enrollment Portal (ePREP). To enroll as an HVS provider, please visit

Individual home visitors are not eligible to enroll as an HVS provider.


Doula Services

Effective February 21, 2022, Maryland Medicaid will provide coverage for doula/birth worker services to Medicaid beneficiaries. A doula, or birth worker, is a trained professional who provides continuous physical, emotional, and informational support to birthing parents before, during, and after birth. Certified doulas serving Maryland Medicaid members will provide person-centered, culturally-competent care that supports the racial, ethnic, and cultural diversity of members while adhering to evidence-based best practices.

Only a doula who meets the following certification and participation requirements may enroll with Medicaid to administer doula services:

  • Be at least 18 years of age
  • Obtain and maintain liability insurance
  • Attest to being trained and certified by an MDH approved organization
  • If enrolling as a group practice type, obtain a Type 2/organizational NPI.
    If enrolling as an individual provider, obtain a Type l/individual NPI.
  • Enroll in ePREP as a fee-for-service Medicaid provider
  • Must pass a background check

Eligible providers may now enroll in Maryland Medicaid. Doula providers who meet all the conditions of participation outlined in the Maryland Department of Health Doulas Transmittal No. 1 dated March 11, 2022, are eligible to enroll as either an individual or group “Doula Provider” type through ePREP. To enroll as a doula provider, please visit eprep.health.maryland.gov.

For questions related to Maryland’s Doula Services Program or provider qualifications, please contact MDH at mdh.medicaidmch@maryland.gov


Physician Support Packet for COVID-19

The Maryland Medicaid Program, in collaboration with the State’s nine Medicaid managed care organizations, has developed the Physician Support Packet for COVID-19, which is a compilation of information and resources to support your practice in caring for patients in today’s COVID-centric environment.

The Physician Support Packet for COVID-19 is available at the Maryland Department of Health’s website at . Please review this information, which we hope is helpful as you continue provide care during the COVID-19 pandemic.


Provider Satisfaction Survey

As a health plan that strives to ensure the highest quality of care to our members, it is important for us to ensure that we are also providing the best experience to our network providers. On an annual basis, we request your feedback through our Provider Satisfaction Survey.

Please let us know how we are doing and how we can continue to improve your provider experience with our health plan. Completed surveys may be returned by fax at 410-433-4615 or via email to providerrelations@jaimedical.com. We look forward to hearing from you!


Diabetes Prevention Program

We wanted to share some exciting news with you! Jai Medical Systems is offering a Diabetes Prevention Program (DPP) for all qualified members. DPP is a yearlong, lifestyle change program for members who are at risk of developing type 2 diabetes. Members may self-refer to a DPP program, but we hope you will help identify patients in your practice who qualify for the program. We believe
that a recommendation from the patient’s trusted Primary Care Provider would help encourage patients to actively participate in the program.

To qualify for this program, members must be overweight or obese and have elevated blood glucose levels or history of gestational diabetes. Jai Medical Systems members can sign up easily online through Omada Health at omadahealth.com/jaimedicalsystems.

We hope that you will help identify and refer your patients who may benefit from participating in the Diabetes Prevention Program.


Public Health Emergency Update

Due to the continuation of the Federal public health emergency, Maryland Medical Assistance has extended the deadline for Medicaid recipients to renew their benefits. Though the deadline for Medicaid
redeterminations has been extended, we request providers encourage Medicaid recipients to complete their redetermination application when they receive it in order to prevent any lapse in coverage.  Medicaid recipients should also be reminded to keep their contact information up-to-date in order to receive important mailings from the State and Jai Medical Systems.

If there is a Jai Medical Systems member in your care that needs additional information regarding their redetermination or assistance with the redetermination process, please connect them with our Customer Service Department at 1-888-JAI-1999.

Provider Credentialing & Contact Information

In order to join and maintain participation status with the Jai Medical Systems network, each provider must successfully complete our Credentialing and Recredentialing process in a timely manner. We also kindly request that all providers keep us up-to-date with the most current information about their practice.

Lastly, please also ensure that all staff in your office are aware of their participation status with Jai Medical Systems. We do not want patients turned away due to miscommunication. Please feel free to call
the Provider Relations Department at 1-888-JAI-1999 with any questions.


Provider Portal

There are many services available online to both our members and providers. The resources listed in the chart below 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 today at 1-888-JAI-1999.