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Knowledge is power.

What can you do with the power of true cost transparency?
Set up a demo and see for yourself.

Why Choose AMS?

Providing insight and clarity into high cost claim issues

Focus Points

Specialty Drugs: Specialty drugs comprise just 2% of total prescription volume but account for 40% of spend.


Medical Implants: The U.S. spends more than $150 billion - 6% of the total medicl costs - a year on medical implants.


Catastrophic Diagnoses: In 2018, Catastrophic multi-million-dollar cases made up 2.2% of claimants but generated 23% of total stop-loss reimbursements.

AMS is the leader in strategic intelligence software for clarity into complex claims. We solve the need to address the affordability of care with a targeted focus on Specialty Pharmaceuticals, Catastrophic Diagnoses and Medical Implants.

AMS’ Predict Suite combines technology, clinical expertise, financial insight and data science into an easy to deploy, subscription-based service that brings strategic intelligence and risk mitigation to high cost claims issues. Simply put: Knowledge is Power.

Using cloud based, HIPAA compliant artificial intelligence, Predict FACS delivers superior payment integrity on post-adjudicated, pre-payment specialty pharmaceutical, catastrophic diagnosis and medical device claims in real-time to successfully identify and flag items that warrant additional review. FACS is your next best move in payment integrity.

Data is what AMS does

But data without context, nuance and clarity is useless. AMS is comprised of industry professionals who are not only specialists in their particular areas of expertise, but are innovators as well.

The strategic intelligence that AMS provides solves your most complex business challenges—and the results are presented with a simplicity you never thought possible.

The AMS team is resolute about bringing groundbreaking clinical and financial insight for payment integrity and risk management issues into the hands of our members.

This is what keeps AMS at the vanguard, and what sets our clients up for success.

Why chose AMS? Data. Innovation. Expertise. The AMS difference is clear.

Data

Our healthcare data comprises 115 million claims lines and over $50 billion in charges including claims from: TPAs, ASOs, and Stop Loss Carriers; tens of thousands of EOB’s; thousands of medical reviews; cracks open the black box of implant prices; provides real-world pharmaceutical pricing; ID’s hidden & complex claims.


Innovation

Our cloud-based platform delivers strategic intelligence on major cost drivers in payers' book of business. Its wide array of pioneering features provides them with a greater depth and breadth of business knowledge than ever before, helping payers predict future outcomes, automatically detect anomalies, and quickly & easily sift through noise so they are able to work smarter, not harder.


Expertise

AMS consists of a tenacious team of clinicians, data scientists, and software industry veterans who are dedicated to solve problems pertaining to complex healthcare claims. With years of industry acumen and experience, AMS experts are laser-focused on providing solutions to the disproportionate impact Specialty Drugs, Catastrophic Diagnoses and Medical Devices have on overall medical cost trend increases.


Demonstrated ROI

Deep knowledge in a user friendly package

Powerful solutions within the Predict Suite

Increase volume and accuracy

New solutions to old problems

Stacy

Stacy Borans, MD,

Founder and Chief Medical Officer

Dr. Borans is the Founder and Chief Medical Officer of Advanced Medical Strategies (AMS). AMS is the leader in strategic intelligence software for clarity into complex claims. It was founded with the purpose of combining technology, clinical expertise, financial insight, and data science to help manage ... READ MORE and mitigate the disproportionate impact catastrophic claims, specialty pharmaceuticals, and implant costs have on overall medical cost trend increases.

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, and podcasts, in addition to hosting webinars on a regular basis. Through AMS, Dr. Borans has streamlined the way payers all across the healthcare spectrum can better understand and address the most costly and complex claims problems they encounter every day.

Prior to forming AMS, Dr. Borans was Medical Director at Executive Health Resources, where she oversaw insurance denial management, appropriateness of care, and length of stay program in over 50 hospitals spanning 15 states. She began her professional career in medicine as a private practice physician at Fountainville Medical Specialists in Doylestown, PA.

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.

Stacy is the volunteer President of the Board for a no-kill cat shelter and rescue non-profit organization. She also boxes, loves to travel, and is a master mixologist.

Peter

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... READ MORE 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, reviews medical necessity and experimental concerns and directs 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.

Jay

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... READ MORE 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.

Lee

Laura A. Conte

Chief Claims Officer/General Counsel

Attorney Laura A. Conte is AMS’ Chief Claims Officer and General Counsel. Laura manages the legal affairs of AMS on a broad range of matters. Working in the insurance industry since 1989, she became an Attorney in 2010, specializing in Healthcare Law, Insurance and Advocacy. ... READ MORE Attorney Conte is licensed to practice in the Commonwealth of Massachusetts and has been admitted to the United States District Court. She has affiliations with the Massachusetts Bar Association, the Federal Bar Association and the American Bar Association. Attorney Conte has won two prestigious legal awards in Motions/Pleadings and Arbitration/Mediation. Laura possesses special skills in healthcare compliance, contract writing and negotiations.

Laura is a busy mom-a-ger to her very athletic teenage daughter who will be going off to college before she knows it. She is also a proud mom to her adult son who recently received his Master’s Degree from BU for Applied Business Analytics Management.

Derek

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... READ MORE 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.

Stephanie

Stephanie BeIschner,

Vice President of
Client Relations

Stephanie Belschner serves as the Vice President of Client Relations for Advanced Medical Strategies. In addition to spearheading relationship management and outreach, Stephanie develops and implements strategies for pursuing new business, ... READ MOREdelivers educational presentations, and determines short- and long-term resource requirements. As part of the executive team, Stephanie promotes the company’s products, services, and accomplishments by directing sales and marketing initiatives. 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.

When Stephanie is not supporting the Predict Suite Member Community, you can find her cooking up something delicious in the kitchen or organizing a family event.

Adria

Adria L. Garneau

Chief Operating Officer

Adria L. Garneau, CEBS, is Chief Operating Officer of Advanced Medical Strategies. She has worked in the insurance industry since 1980, providing reviews of managing general underwriters, third party administrators, and health maintenance organizations; audits of provider excess and HMO reinsurance claims; verification ... READ MORE 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 is responsible for agenda planning and coordination of AMS’ Claims Symposium for Predict Suite members, stop loss, excess carrier, and reinsurer claims and underwriting professionals, Ms. Garneau holds a Bachelor of Science Degree in Economics and Associates Degrees in Accounting and Business and Administration. She loves travel, books, and music, and joins Dr. Borans in being a Master Mixologist.

Alice

Alice G. Jamba, RN,

Vice President 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... READ MORE 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.

Lee

Lee Patrick, RN, BHA, MBA, CPHRM, HEM, CPASRM,

Vice President, Predict Suite

Lee Patrick is a detail-oriented nursing professional with extensive, progressive healthcare management expertise with experience in Risk Management and Patient Safety, Process Improvement and Case Management, ... READ MORE Patient Satisfaction and Customer Service, Operations and Budgeting, Healthcare Informatics and Software Development, Organizational Restructuring and Integration, Administration, Grievances, Appeals, and Medical Review. Her experience includes the areas of acute care; physician office practice; acute, subacute, and post-acute physical rehabilitation; long term acute care and long-term care; as well as managed care insurance, independent review organization external appeals, and healthcare information technology. She is a certified professional in healthcare risk management (CPHRM) and has served on the Board of the Philadelphia Area Society for Healthcare Risk Management (PASHRM), a state chapter of the American Society for Healthcare Risk Management (ASHRM), as Secretary, Webmaster, and President. She is also currently on the Board of the Pennsylvania Association for Healthcare Quality (PAHQ) as Webmaster and is a member of the Greater Delaware Valley-American Nursing Informatics Association (GDV-ANIA) formally known as the Delaware Valley Nursing & Computer Network (DVNCN). She also holds a certification in healthcare environmental management (HEM) and is a certified professional in aging services risk management (CPASRM). In May 2017, she began working with AMS supporting the core services and Predict suite of products.

Lee

Nic Andre,

Product Development Manager

Nic Andre is Advanced Medical Strategies’ Product Development Manager. Reporting directly to the CIO, he works alongside the IT team to design, develop, deploy, and maintain the myriad of updates periodically released within the Predict Suite. Nic’s duties also include the conception and creation... READ MORE of the next generation of AMS products, such as Predict FACS.

Having worked at AMS since his first year of college, his skillset is finely-tuned to the self-funded industry. Nic is a Certified Self-Funding Specialist (CSFS) and holds a degree in finance from the Isenberg School of Management at UMass Amherst.

Outside of AMS, Nic plays the keyboard and is an expert skier. Nic also enjoys mountain biking, reading philosophy, and working on cars that are nearly as old as he is.

See the Predict Suite in action today.