Verification of benefits

A thorough and timely approach to verifying benefits that result in increased admissions and insight
into claims payments.

Appeals Process

Detailed and extensive appeal thesis written by a licensed clinician. We exhaust all levels of the appeals process including the external appeal to the plan regulator.

Analytics & Reporting

Custom-built KPI reporting for each client’s unique needs. Know the health of your business in one
easy to navigate dashboard.

Utilization Review

Licensed clinicians manage preauthorization, concurrent authorization, and peer-to-peer
appeals.

Claims &Tracking

A team of dedicated billing professionals works diligently to submit and track claims throughout the entire adjudication process.

Quality Assurance

A dedicated team of analysts reviews each claim as they adjudicate to ensure accurate payment and posting.

Relationship Management

Our Relationship Management Department is divided into teams.  This team approach allows for greater responsiveness to our facilities’ and their patients’ questions and concerns.

Reporting

Live real-time reporting portal available to facilities 24/7/365.  Reporting allows for insight into the utilization management and billing process for each client and SJ as a whole.

Billing/Collections

SJHIA provides all the tools you need for managing patient billing and collections so you can speed up the collection process and improve the patient experience.