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Why Choose AMS?

Expertise. Innovation. Relationships. The AMS Difference is clear.

Experience A Higher Level Of Care.

When selecting business partners, there is always some leap of faith…relying on an external organization to improve some deficiency within our own business. We at AMS fully understand that responsibility and commit to providing you unparalleled tools and resources to better your business. By providing clinical expertise, financial understanding and cost containment insights at every touch point, our business partners value the AMS consultative approach.

Our Promise to you

♦ Demonstrated ROI

♦ Deep knowledge resource in a user friendly package

♦ Improve profitability by increasing volume and accuracy

♦ Powerful solutions to managing claims with the Predict Suite

♦ Business partner who understands and will lead you to new solutions to old problems

Our promise comes from our unwavering faith in our clinical and financial expertise. We will personally support our recommendations to any and all parties if they are ever challenged or questioned. AMS consists of physicians and financial professionals whose only business is assessing the bottom-line cost of treatments and clearly defining the clinical basis of those costs. We wouldn’t consider this a guarantee if we weren’t completely confident in our depth of knowledge and experience. We are experts and will base our recommendations on the facts as we see them; you should have that confidence, too.

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Clinical

Gaining a clinical perspective means gaining possibilities, comprehension, and strategy. Without a clinical overview, there are missed opportunities to reach the best outcome. AMS physician-led reviews and reporting give you a fuller picture of how treatments relate to costs.

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Political
It isn’t just dollars and cents

We not only look at the claim in dispute, but also its context. Will this be worth breaking a business relationship? Will this be a bigger political battle than it’s worth? AMS will personally consult with you and your team to determine the true cost of a claim, factoring the invisible but ever-important role of payor politics and relationship dynamics into negotiation strategy. Only a company with the level of depth and experience in both the clinical and financial fields could provide such a holistic look at your catastrophic claim reduction.

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Financial

A $5,000 claim simply cannot be treated like a $50,000+ claim. We are dedicated to directing our clients toward solutions at every level of claim, but high-dollar and catastrophic claims require a particular level of care, clinical expertise, and financial review. When you bring your high-dollar and catastrophic claims to AMS, we believe that we owe you the best financial outcome for those claims.

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Executive Bios

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    Stacy Borans, MD

    Chief Medical Officer and Founder

    Dr. Borans is the Founder and Chief Medical Officer of Advanced Medical Strategies (AMS). AMS is a healthcare payer services company providing claims integrity analytics and decision support solutions. It was founded with the purpose of combining clinical expertise and experience with financial sensitivity and understanding to give clients high-level cost containment insight and guidance. This is done primarily through the AMS Predict Suite of software, but also with services such as independent medical reviews, underwriting opinions and lasers, provider bill negotiation, provider bill audits, Medicare repricing and physician consulting. AMS also conducts aggregate & specific claim audits, as well as reinsurance, MGU, and TPA reviews. Further, Dr. Borans is the outsourced medical director for several companies within the stop-loss industry.

    Dr. Borans is the architect of AMS’ Predict Suite of solutions. Collectively, the Predict Suite is a web-based repository of clinical & financial analytics for proactive management of catastrophic claims. This subscription-based service is comprised of three components: PredictRx, PredictDx, and ImplantDx.

    PredictRx is AMS’ specialty drug database that evaluates and predicts dosing regimens and their associated costs. It is designed for end users to quickly obtain detailed information on over 450 high cost pharmaceuticals including approved indications, common off-label usage, adult/pediatric dosing regimens, HCPCS & NDC (Specialty Drug) coding, and additional physician researched information. High cost drugs are exactly what is moving the needle in claims today and PredictRx has established itself as the go-to reference tool for these issues.

    PredictDx is AMS’ diagnosis index that combines clinical and financial analytics to address the challenges associated with managing, reimbursing, and underwriting catastrophic claims. It details therapy pricing, risks, accepted treatments and other information related to more than 220 of the costliest catastrophic diagnoses, enabling health care payers to more accurately predict their liabilities for an illness; it is used by some of the largest companies in the industry.

    ImplantDx is the only fully transparent medical implant & device cost directory available today. It offers clients the references they need for cost containment with on-demand analytics. Real prices for medical-surgical hardware remains opaque. ImplantDx lifts the veil to reveal actual provider-reported implant data and pricing by supplier, category, and/or item or SKU.

    Dr. Borans is a respected and much in-demand speaker at seminars worldwide for claims professionals. She has appeared on a multitude of educational panels, workshops, podcasts, and hosts her own webinars on a regular basis. Through AMS Dr. Borans has streamlined the way payers all across the healthcare spectrum can predict and manage costs associated with trigger diagnoses.

    Dr. Borans earned her medical degree from Hahnemann University in Philadelphia, PA. She completed an internal medicine residency at Thomas Jefferson University Hospital, also in Philadelphia. She holds a BA in Biology from Brandeis University.

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      Peter Borans

      Co-Founder & President

      Peter Borans is the president of Advanced Medical Strategies (AMS) a company he co-founded in 2003. AMS offers healthcare companies a proactive approach to physician medical management. AMS specializes in the implementation and management of superior and cost effective revenue solutions for the self-insurance and managed care industries without in-house medical expertise. AMS works with Managing General Underwriters, Third Party Administrators, stop loss carriers, and managed care plans to assess both clinical and financial questions on catastrophic claims. AMS assists in cost projection analysis for underwriting risk, reviewed medical necessity and experimental concerns as well as directed educational seminars for claims professionals. Peter oversees all aspects of Finances, Operating, and Marketing of the organization.

      Prior to AMS, Peter was EVP of Sierra Atlantic, an Oracle consulting company based out of Boston that was ultimately acquired by Hitachi. At Sierra Atlantic, Peter reported directly to the CEO and was a member of the executive management team, with full P&L responsibility and $25 Million in booked revenue for 2005. He was responsible for all commercial facets of East Coast’s practice core solutions, software, product and global professional services business, with a mission to provide high-value services and superior customer satisfaction. Prior to Sierra Atlantic Peter was President of Sceptre Database Consultants where he had a key role in building a privately owned 8 person Oracle Outsourcing and Consulting Company to a 25 person, multi-million dollar organization that was ultimately bought by Sierra Atlantic. He was responsible for Sales, Finance, Operations, HR, managing operations by directing and coordinating activities consistent with established goals, objectives, and policies. Also responsible for capital management and managing all internal accounting, financial planning and analysis; including providing leadership for successful planning and reporting of corporate revenue, expense and operating performance goals.

      Prior to Sceptre Database Consultants, Peter enjoyed a long career with Back Bay Restaurant Group rising from Assistant General Manager to becoming a member of the executive committee responsible for growth and strategic direction of the 35 unit, multi-concept Restaurant Company. As the Vice President of IT/IS, he oversaw and directed all aspects of MIS/IT and IS development, strategy, and deployment for a $100 million restaurant corporation. Peter is a 1993 graduate of the Whittemore School of Business & Economics at the University of New Hampshire.

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        Derek Moore

        Senior Vice President of Business Development

        Derek Moore leads AMS’ sales division. Derek has more than 20 years of business development experience working in self-funding, benefit plan design, stop-loss, claims administration, cost containment and provider network environments. His comprehensive knowledge of the managed care and employee benefits industry is extensive. Moore’s expertise in fostering relationships with large employers, third party administrators, labor unions, insurance carriers, HMOs, government employee health plans, brokers and benefit consulting firms is held in the utmost regard.

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          Jay Donoghue

          Chief Information Officer

          Jay Donoghue is Advanced Medical Strategies’ Chief Information Officer. Hired in July 2015, Jay has long worked behind the scenes: He developed the first client portal and provided a myriad of IT services all before officially joining the AMS team.  As Chief Information Officer, Jay is responsible for driving development and support for all things IT, including the Predict suite of software, internal HIPAA compliance, and the aforementioned client portal maintenance/updates.

          Prior to his employment at AMS, Jay enjoyed a twenty-year career at Analog Devices. At the onset, Jay designed hardware and software to perform electrical verification of semiconductor products. Moving forward, he turned his focus to software, managing a team responsible for the design, development, and support of applications to drive the industrial supply chain. This included enterprise data integrations, invoice verification and manufacturing process instructions. Finally, Jay rose to Quality Engineering Manager, leading a group of engineers responsible for customer quality issue resolution using the 8D process.

          Jay obtained his Bachelor of Science Degree in Electrical Engineering from the University of New Hampshire, and is a certified ASQ Six Sigma green belt.

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            Adria L. Garneau

            Chief Claims Officer

            Adria L. Garneau, CEBS, is Chief Claims Officer of Advanced Medical Strategies. She has worked in the insurance industry since 1980. From 2010 to 2012, Ms. Garneau was President and Chief Claims Officer of Marble Arch Services, LLC, providing claims oversight and auditing, medical management, and business development consulting to Harbour Life & Reinsurance Company, Ltd., a Bahamas-based reinsurer, and to International Insurance Agency Services, LLC, and its sub-MGUs. From 1991 to 2010, Ms. Garneau was an officer and shareholder of Northshore International Insurance Services, Inc. (NiiS), a claims auditing and consulting firm. Her responsibilities at NiiS included reviews of managing general underwriters, third party administrators, and health maintenance organizations; audits of provider excess and HMO reinsurance claims; verification audits of aggregate and specific excess claims; employer sponsored health plan administrator reviews; reinsurer and carrier audits; and expert witness evaluations and testimony in arbitration and litigation matters. She also was responsible for agenda planning and coordination of a three-day educational conference for stop loss, excess carrier, and reinsurer claims and underwriting professionals. From 1986 to 1991, Ms. Garneau was an expert consultant to rehabilitation and skilled nursing providers to assist in identifying and accessing sources of insurance and other funding for catastrophically injured patients. She was Director of Administration for a health maintenance organization from 1984 to1985 and Claims Manager for a third party administrator from 1980 through 1984. Ms. Garneau holds a Bachelor of Science Degree in Economics and Associates Degrees in Accounting and Business and Administration. She is a member of the International Foundation of Employee Benefit Plans and the Self Insurance Institute of America.

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              Stephanie BeIschner

              Director of Client Relations

              Stephanie serves as Director of Client Relations for Advanced Medical Strategies. In addition to spearheading relationship management and outreach, Stephanie develops and implements strategies for pursuing new business, delivers educational presentations, and determines short- and long-term resource requirements. She possesses a vast knowledge in the handling of medical malpractice, personal injury, and workers compensation claims as well as other areas of litigation.

              Stephanie’s formidable client relations, public speaking, networking and leadership skills developed from her career experiences both with private firms and more than a decade of public service in the state of Massachusetts. Building trust, confidence and goodwill with AMS clients is Stephanie’s top priority and the driving force in her success

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                Alice G. Jamba, RN

                VP of Clinical Services

                Alice G. Jamba is the Vice President of Clinical Services for Advanced Medical Strategies. Alice has worked in health care since 1974, starting as a staff nurse in Emergency Services at New York-Presbyterian University Hospital of Columbia and Cornell in New York. Subsequently, Alice garnered additional experience in the fields of maternal-child, occupational health and psychiatry/substance abuse, bolstering her already-solid clinical background.

                In 2003, Alice entered the insurance arena at Health Market in Norwalk, CT in the small group underwriting division. From there she gained insight into provider perspective, tackling utilization review in the areas of mental health. Alice moved into the stop-loss industry in 2007 working at Greenwood International Insurance, an MGU in Boston, Massachusetts. She worked actively with Greenwood’s underwriting team on cost projections and high risk liability for full groups as well as individual clients. In addition to underwriting, Alice managed the clinical progress of active clients by advising on payment of high dollar claims. Alice has worked at AMS since 2014. She holds a nursing degree and a Bachelor of Science in Psychology.