WellSky's HCBS (Home and Community-Based Services) software provides an integrated solution for managing Medicaid waivers, the Older Americans Act, and other state or federally funded programs. The platform automates the entire care process, including eligibility determination, intake, assessments, and claims adjudication, enabling more comprehensive care management. Each operating agency can configure the system to support its unique processes, ensuring flexibility and adaptability. The software facilitates provider management by automating applications, confirming credentialing and re-certification requirements, expediting referrals, and ensuring quality performance. To maintain compliance with HIPAA and other privacy standards, WellSky employs role-based permissions, sharing only the minimum necessary data. The system also supports waiver-specific waitlists, implementing a documented, objective selection process based on state priorities. Robust reporting capabilities allow access to hundreds of standard reports and the generation of custom reports to assess operational performance, track outcomes, and comply with funding source requirements. Budget management features meticulously track state payouts, breaking down claims into appropriate state and federal match ratios, and providing budgeting utilities and financial reports to maximize the number of consumers accepted into programs. WellSky's modular approach complies with Medicaid Information Technology Architecture (MITA) Conditions and Standards as outlined by CMS, simplifying adherence to the HCBS Quality Framework, Settings Rule, and various waiver quality requirements. Features:

• Care Management: Automates eligibility, intake, assessments, and claims processing for comprehensive care coordination.
• Provider Management: Streamlines provider applications, credentialing, referrals, and performance monitoring.
• Incident Management: Ensures data security and compliance with health and welfare requirements through role-based permissions.
• Waiver-Specific Waitlists: Implements objective selection processes based on state-defined priorities.
• Reporting: Offers extensive standard and customizable reports to monitor performance and outcomes.
• Budget Management: Tracks state and federal fund allocations, providing tools to optimize budget performance.
• Compliance Support: Aligns with HCBS Quality Framework and HIPAA standards, utilizing role-based security and comprehensive reporting.