Tempus Unlimited depends on EDI Autoclaim to meet its growing Medicaid billing demand

EDI Autoclaim helped Tempus improve cash flow with automations that saved over 500 hours a year in staff overtime alone and helps them reconcile all claims to the penny each week.
$350 million
in Medicaid claims processed each year
500
hours a year saved in staff overtime
4 million
claims billed each year

Background​

Tempus Unlimited delivers Home and Community-Based Services (HCBS) to support children and adults with disabilities to live as independently as possible in the community and at home. 

A Massachusetts-based non-profit organization, Tempus provides personal care services, personal care management and fiscal intermediary services (also known as Fiscal/Employer Agent services) to over 20,000 residents in the state, helping to foster and support independence and ensure a better quality of life in the community. Tempus also provides Adult Family Care services, classes for adults, a Supported Living Program and employment services.

Through personal involvement, individual decision-making is supported and encouraged to enhance a person’s control over their own lives and to foster self-sufficiency in all of Tempus’ services and programs. Many of the individuals served by Tempus utilize self-directed services, also known as consumer-directed services and participant-directed services. 

Tempus program participant with staff at an annual event. Tempus program participant with staff at an annual event.

Challenge

Tempus was looking for a Medicaid billing and eligibility system that could keep up with its volume of claims and growing billing demands. Before Annkissam’s EDI Autoclaim, they were billing over 60,000 claims every week. The system they were using couldn’t keep up. Tempus needed to bill faster. They needed robust Medicaid claiming automation and an option for rarely-used paper forms. Tempus needed the best Medicaid billing software.

“The system we had couldn’t handle the volume of data,” said Laura Fraticelli, billing manager at Tempus. We had to archive data, even as recently as in the same year. This was a problem because we can bill for services within a year and need to be able to keep a large volume of data over time.”

Additionally, Fraticelli explained, they would have to commit staff resources over every weekend to import the service data into their prior billing system because it would take more than 36 hours to complete.

That’s where EDI Autoclaim came in. EDI Autoclaim is Annkissam’s Medicaid billing system built for Home and Community-Based Services. EDI Autoclaim handles thousands of service claims in seconds and processes a claim up to 60 times faster than keypunching manually. Now Tempus imports data and creates the 837p electronic Medicaid claiming file in less than half the time with no manual steps.

Solution and Benefits​

Annkissam’s EDI Autoclaim helped Tempus significantly grow their programs, with increased efficiencies in their Medicaid billing process. Since using Annkissam’s EDI Autoclaim, Tempus increased their Medicaid billing claim volume over 16% all while reducing staff hours dramatically. Tempus currently bills over 70,000 Medicaid claims weekly and over 4 million claims a year. 

“By far, the biggest win with the new software is increased speed and time savings!” said Fraticelli. “We can queue up multiple functions at the same time and easily save over 500 hours in staff overtime compared to before.

With EDI Autoclaim, Tempus is now able to do more electronic claims, including the 837p and 835, and increase their automated processes for added efficiencies. Because they can submit more claims faster, they are also getting paid more quickly. Using EDI Autoclaim helped Tempus increase cash flow while claiming over $12 million in claims every two weeks.

By far, the biggest win with the new software is increased speed and time savings!

“Now we do very little manual, posting or even paper claims, even with new payers. Being able to automate so many steps was a big change for us.” said Fraticelli.

EDI Autoclaim’s user interface and dashboard makes it easy to see a summary of everything billed, paid and pending at any point in time. The dashboard turned out to be a big unexpected win for Tempus. While claiming nearly half a billion dollars annually, Tempus uses EDI Autoclaim’s accounting dashboard to reconcile all claims to the penny each week

“The accounting screen is amazing! It helps us to always be reconciling, and we’re able to constantly make sure that what we bill matches to the penny. I don’t think we realized how important it would be to our daily process.” said Fraticelli.

Some of the biggest benefits are getting paid quickly, while focusing staff time on high value work. 

"Using EDI Autoclaim helped Tempus increase cash flow while claiming over $12 million in claims every two weeks."

“Before we were spending all our staff time doing the billing and manual posting, only looking at rebills and denials once a month when we could find time.” said Fraticelli. “Now it’s so much better. Everything is more current and we can stay up to date, even completing reconciliations every week.”

Annkissam’s approach to working with clients is partnership. From the start, Annkissam worked closely with Tempus to match their billing workflows to the EDI Autoclaim system and developed understanding of Tempus' claims, services and payer rules. Autoclaim logic was configured so that each payer Tempus submits claims to receives claims in only the formats they prefer, per the payer’s rules. And further, Annkissam helped Tempus billing staff on a data conversion process, also known as a data migration to help ensure a successful launch with EDI Autoclaim.

“The Annkissam team is always helpful, personable and a pleasure to work with.” said Fraticelli. “Their response time to any issue is quick and efficient. And the dialogue is always open to what we can do together as program changes come up. It’s a great collaboration.”

While claiming nearly half a billion dollars annually, Tempus uses EDI Autoclaim’s accounting dashboard to reconcile all claims to the penny each week.

More about EDI Autoclaim

EDI Autoclaim offers best-in-class Medicaid billing and revenue cycle management for Home and Community-Based Services (HCBS). Read more about the features that set EDI Autoclaim apart from other Medicaid billing systems and why clients like Tempus choose to grow their billing programs with Annkissam.

Annkissam’s EDI Autoclaim system features real-time eligibility verification in Massachusetts with a direct SOAP connection to the MassHealth Medicaid Management Information System. While it also offers eligibility verification with 270 and 271 file formats, our Massachusetts clients prefer the real-time access. Annkissam clients like Tempus can obtain client and consumer Medicaid and service eligibility information in batch or individually in real-time.

Tempus program participants enjoying the winter dance. Tempus program participants enjoying the winter dance.

For HCBS Medicaid billing, EDI Autoclaim can bolt on to an HCBS provider’s front-end system, whether it is an Electronic Health Record, Practice Management System, Case Management software or even Electronic Visit Verification system. EDI Autoclaim can take in claim data from other systems electronically and bill a variety of payers, including state fee-for-service, Managed Care Organizations (MCOs), Health Maintenance Organizations (HMOs), speciality payers and private pay.

EDI Autoclaim includes robust and customizable rules, plus claim scrubbing, to ensure claims are properly billed in compliance with each payer’s rules before they are submitted. The Autoclaim feature further ensures that each payer receives claims, adjustments, resubmittals and voids in the format each payer requires. 

Aging and accounts receivable can be viewed in highly granular detail or in several summary options to ensure the revenue cycle management (RCM) of HCBS providers is tightly managed, all while reflecting HCBS Medicaid claiming workflows. With EDI Autoclaim, Annkissam clients like Tempus and other HCBS providers know just where to focus their claim resolution time and energy through robust dashboards and reporting