FMS Engine

FMS Engine boosts your operations in 5 key areas

Enrollment and Onboarding

  Online and on time. 

• Online, self-service. Participants and employees complete key enrollment and new hire forms online
• Paper, faxes and mailing - eliminated
• Expedite enrollment and reduce errors with customizable built-in workflows and rules
• Your staff focus on people, not program complexity. FMS Engine handles that

Budget and Authorization Management

  Automated and powerful. Built for self-direction.

• Easily create participant budgets from program services and rates
• Track budgets and authorizations in units or dollars
• Manage complex budget and authorization rules
• Ensure utilization is appropriate at annual, monthly, weekly, daily and other intervals
• Automatically budget for employer tax expenditures
• Manage co-pays, deductibles, and cost shares
• Participants, care managers, state, and families can see the budget and expenditures on demand

Communication and Tracking

  Structure for the unstructured.

• Track all customer service activity in real-time
• Allow staff and selected stakeholders to see every communication that has taken place for a participant
• Create tasks and action items to assign to staff and departments
• Ability to attach documents
• Automatic notifications to remind staff to take action as needed

Timesheets, Invoices and EVV

  EVV. Purpose-built.

• Mobile-friendly timesheet and invoice entry
• EVV purpose-built for self-direction by meeting the 21st Century Cures Act requirements in the least-restrictive way for participants
• Notifications for unauthorized and over-budgeted expenditures
• Quality controls built into workflows designed around your program, payer & business rules
• Integration with external payroll and accounts payable software

Billing and Eligibility

  Do it fast. Do it right. 

• Get paid on 98% of claims on the first try
• Process claims 60xs faster
• Bill Medicaid, fee-for-service, managed care, Veterans Health Administration, and other payers with powerful electronic claims, using batch electronic files including 837i and 837p
• Automate claim scrubbing to prevent incomplete billing and collect more on your claims the first time, eliminate the need for a clearinghouse
• Manage aging with powerful reports and streamlined workflows, tracking accounts receivable and aging by program, payer, consumer, with reason for denials, allowing for easy follow-up and re-billing 
• Save time with batch rebill and other batch action features for more time savings, such as producing pre-populated Forms CMS 1500 and UB-04
• Check Medicaid eligibility in batch with automated 270/271 and prevent claims for ineligible consumers