For State Medicaid HCBS and MCO programs

From assessment to claim — every HCBS workflow, audit-defensible by design.

Case management, service authorization, Medicaid billing — built into one connected record. Ideal for state and local HCBS providers running waiver programs.

app.monami.io / medicaid-hcbs
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DD
DD Services
HCBS Waivers · 2025
JR
SmartLists HCBS Access Rule · 2025

HCBS Access Rule · 2025 Compliance

Compliance-ready 90 days to CMS deadline · 18 waivers tracked
Waivers in compliance
2 awaiting settings review
Choice documented +6.1 pts
94.0%
Settings compliant +2.4 pts
97.1%
Modifications justified +14 pts
82.0%
Needs your attention 2
CL
Community Living Waiver
3 settings missing integration documentation · review by Mar 14
SE
Supported Employment Waiver
Awaiting QIDP modification sign-off · 4 ISPs queued
01
HCBS Access Rule, captured at the source
Every Access Rule data point — choice, control, integration, modifications — embedded in the assessment, not added afterwards.
02
Validated assessments that feed the whole record
InterRAI HC, MDS-HC, state-specific LOC tools — scored automatically and flowed directly into eligibility, the ISP, the service authorization, and waitlist prioritization. No re-keying, no parallel spreadsheets.
03
Provider network at scale
Qualifications, credentialing, contract management, and oversight — for every contracted HCBS provider in the network, with re-credentialing automated.
Why switch

We hear the same two complaints from every team we talk to.

Both have the same root cause: your software was built before anyone in your job description was expected to work this way. Mon Ami exists because that's no longer okay.

Reason 01
Your software fights you.
Reason 02
Your data is trapped.
01
Reason #1

Your software fights you.

Ten clicks to log a phone call. A new window for every form. Workers who print, write, then re-key the same information. We've all worked in these systems — and we won't ship one.

What most teams are using today
CARES Client Manager — [CLIENT: WHITFIELD, MARCIA ID# 0047188214] _ ×
FileEditViewRecordeportsToolsWindowHelp
Demographics Eligibility Services Assessments Care Plan Notes Provider Billing
WHITFIELD
MARCIA
L
XXX-XX-4421
04/12/1941
F
02 - WHT/NH
W - Widowed
214 PINEHURST CIR APT 4B
PINEHURST
NC
28374
37125
04
SOUTH CENTRAL
02
(910) 555-0117
(910) 555-0282
NC0918274421
1EG4-TE5-MK72
Service Enrollments
SVC
PROVIDER
UNIT TYP
START
END
FUND CODE
STATUS
318
COASTAL AAA
MEAL
02/04/24
TII-C1
ACT
412
COASTAL AAA
HOUR
01/18/24
TII-B
ACT
218
TRIANGLE TX
TRIP
03/02/24
04/30/24
STA-FN
CLS
506
FAMILY CARE
HOUR
CGV-C
WLT
USER: jmiller SVR: cares-prd-04 SESS: 02:14:38 RECORD 1 OF 14,028 NUM CAPS
Mon Ami
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SU
State Unit
on Aging · FY26
JR
Clients Eleanor "Ellie" Hayes
EH
CLIENT

Eleanor "Ellie" Hayes

ACTIVE
02/14/1943 · age 83 · Asheville, NC
ami-4f82e1c 1 program suspension
Dashboard Profile Notes Activity More
Compliance Alerts ADL Limitations missing & 2 more 3
Pinned Notes Apr 18, 2026
Daughter called — Ellie is hospitalized for an acute event. Pause services through the end of the month.
Key Profile Info
Date of birth 1943-02-14
Gender Female
Poverty line At or below poverty
Living status Alone, at home
02
Reason #2

Every HCBS dollar tied to a documented service.

From Level-of-Care screen through authorization to clean claim — one record, one source of truth, one audit trail when the federal review arrives.

MonAmi
ANALYTICS
Dashboards
Access Rule readiness
Waiver outcomes
ISP completion
Provider qualifications
NCI metrics
SmartLists
Settings under review
ISPs due reassess
Modification queue
Dashboards / HCBS Access Rule · 2025

Waiver Access Rule readiness

Period: 2025 All waivers All settings
Choice documentation captured
94.0%
▲ 6.1 pts vs 2024
Settings compliant
97.1%
▲ 2.4 pts vs 2024
Modifications justified
82.0%
▲ 14 pts vs 2024
Settings characteristics · 12 months
All waiver types · across 18 waivers
Choice Control Integration Modifications
Waiver compliance status
2025 · 90 days to CMS deadline
Compliant · 14
In review · 2
Needs docs · 2
Insight. Community Living Waiver settings without integration documentation dropped from 18 to 3 since Q1 — driven by automated reminders embedded in the ISP workflow. Open cohort
Access Rule
Choice, control, integration captured at source
Validated assessments
LOC + comprehensive in one flow, scored automatically
Provider
Network, credentials, oversight in one place
An industry-leading data and analytics platform — not a CRM with a reports tab.
And yes — every regulation your team answers to is already in the system.
HCBS Access Rule (2024)1915(c) WaiversHCBS Quality Measure SetHIPAASOC 2 Type IISection 508
How Medicaid HCBS agencies use Mon Ami

One platform. The modules that matter for your work.

Mon Ami is modular. Medicaid HCBS agencies typically deploy the highlighted modules below, with the rest available as your needs grow.

LOC & Comprehensive Assessments Core

Level-of-Care screening, comprehensive assessments, and Person-Centered Service Plans — with HCBS Access Rule data points embedded in the flow.

Provider Network Management Core

Credentialing, contract dates, license expiry, training records, and claims history — for every contracted HCBS provider in your network.

Billing Core

Service authorizations roll into clean Medicaid claims — 837P/837I to state Medicaid agencies, MCOs, or your clearinghouse, with validation, denials, and aging tracked in the same record as the underlying service.

HCBS Quality & Audits Core

Annual quality reviews, HCBS-CAHPS workflows, and CMS Quality Measure Set tracking — without spinning up a separate audit project.

Case Documentation Core

Case notes, signed observations, progress documentation, and the audit trail every CMS reviewer expects — captured by case managers and care coordinators across every waiver program.

Waitlist Management Core

Every waiver waitlist, every priority decision, every outreach event — in one record auditors can verify. Configurable priority scoring, automated status updates, and live reporting so when CMS asks 'why this person, why now?' the answer is one click away.

FAQ

The questions directors actually ask us.

If you're evaluating Mon Ami for an RFP or a board, these come up every time. Don't see yours? Get in touch — we'll answer in plain language.

How long does implementation typically take?

Because Mon Ami is a configurable COTS product — not a custom build — you skip the multi-year timelines and risk of bespoke development. Our implementation timelines have agencies up and running in a fraction of the time it takes with our competitors. Weeks, not years.

Can we migrate from our existing system?

Yes. We’ve executed large-scale migrations for state agencies with decades of historical data — including from SAMS, WellSky/Harmony, custom Access databases, home-grown Salesforce builds, and spreadsheets — without data loss. Our migration team handles data mapping, validation, and cutover. And we don’t bill by the hour for it.

Is Mon Ami truly ADA accessible?

Yes — this isn’t a checkbox claim. Mon Ami is built to WCAG 2.1 AA standards and tested with screen readers including JAWS and NVDA. We have blind case managers actively using the product for their daily work, which is the proof point most accessibility claims can’t back up.

How does Mon Ami handle interoperability with our other systems?

We know that your agencies operate within a network, and we routinely integrate with external systems. We have experience integrating with state government systems, HIEs, EHRs, other database solutions, and everything in between. Our architecture makes that straightforward: open REST API, HL7 FHIR R4, secure SFTP, and structured data formats. Interoperability is a design standard here, not a project.

What does your support model look like?

Our support team isn’t just technically sharp — they know your world. They understand aging and disability services, OAAPS and NORS, and compliance requirements, so they can advise on configuration, workflow, and data strategy, not just answer tickets. Response times are excellent, but that’s the floor, not the ceiling. Ask us for client references — they’ll tell you better than we can what the experience is like.

What is Mon Ami's pricing?

Pricing is always scoped to the agency’s unique needs. What we can tell you is what’s always included — no surprise charges. Most enterprise software vendors grow revenue through change orders, seat fees, and storage limits. We don’t. Every license includes, at no additional cost: unlimited user seats, unlimited client and case records, unlimited file storage, adding or amending data fields, forms, and assessments, data export and ad hoc reporting, and all improvement and version updates. Why? Because we believe our incentives should align with yours. Charging per seat quietly discourages agencies from adding new staff — which leads to shared logins and real security risks. Charging for field changes or new reports penalizes agencies for adapting to shifting funding and regulatory requirements. We’ve seen what that model does, and we built ours as a deliberate alternative.

Let's talk

Run HCBS the way the 2024 Access Rule expects.

30-minute scoping call. No slideware. Just a conversation with someone who's done this before.