Dual-track coordination
Financial redetermination and LOC reassessment are tracked on separate calendars; the pack verifies both are scheduled within the required windows and coordinated to prevent lapse.
The most rigorous HCBS waiver renewal pack a home care agency can send.
WaiverGuard assembles a documentation-complete redetermination-and-recertification pack — every required form, every ex-parte data match, the LOC reassessment coordination, the submission checklist, and the dual-track calendar — checked against CMS guidance and state waiver requirements before a specialist releases it.
Every element of CMS CIB 08/19/24Dual-track financial & LOC renewal clocksEx-parte data matching before any client contactSpecialist release on every pack5-business-day SLA
Why renewals fail
A single missed renewal can cut off billable visits for 30–90 days.
Every HCBS waiver client must clear two separate, uncoordinated renewal processes to keep receiving covered home care: financial Medicaid eligibility redetermination and a waiver-specific level-of-care (LOC) reassessment plus service-plan renewal. CMS's own August 2024 guidance acknowledges this is a structural coordination failure — financial eligibility renewal often operates independently from the LOC evaluation, and procedural terminations occur even for beneficiaries who remain fully eligible, a failure mode CMS says can pose a risk to beneficiaries' health or result in institutionalization.
For the home care agency, an uncoordinated lapse is not an abstraction: it is an immediate, unbilled visit, a client technically disenrolled mid-episode-of-care, a 30–90 day reinstatement window during which no one gets paid, and a real risk the client re-enrolls with a competing agency. Most agencies run this by hand, from memory, across dozens of waiver programs. That is exactly where completeness gaps hide.
WaiverGuard exists to close that gap with a single, exhaustive standard applied identically to every file.
21.6 pts
increase in ex-parte match rate from automating renewals (Health Affairs, Nov 2025)
The benchmark
Measured against CMS guidance and state waiver requirements — subsection by subsection.
We do not summarize the rules and hope. Every pack is scored against a versioned rule pack tied to CMS CIB 08/19/24 and the specific state waiver program. These are the provisions each pack is held to.
Ex-parte renewal first
Before any client contact, the pack runs an ex-parte data match against available data sources (e.g., state data exchanges, SSA) to attempt renewal without burdening the client.
LOC reassessment timing
The level-of-care reassessment is verified to occur no later than the annual renewal date, and the service-plan update is coordinated with the reassessment.
Emergency flexibilities
If the state has approved Appendix K flexibilities (e.g., extended renewal timelines, telephonic signatures), the pack applies them and documents the authority.
Notice and fair hearing
The pack includes a checklist for required adverse-action notices and fair-hearing rights, with timestamps verified against state notice requirements.
Person-centered service plan
The service-plan renewal is verified to include the required person-centered elements, with evidence of client or representative participation.
How a pack is built
Intake to specialist release, with deterministic gates the AI cannot overrule.
AI extracts and drafts. Deterministic rules — running as code, outside the model — decide what is complete. A human specialist signs every release. That order is never reversed.
01
Renewal Gap Scan
Upload your client roster and current renewal status. We return a free completeness read: which clients are approaching a renewal window on either track, and what documentation is missing.
02
Evidence & data matching
As your authorized clerical agent, we run ex-parte data matches against state data exchanges, SSA, and other available sources to pre-fill forms and minimize client burden.
03
Grounded drafting
The required forms (e.g., financial renewal application, LOC reassessment request, service-plan update) are drafted from your validated data and the state waiver rule pack into field-locked templates — no legal opinions, no invented facts.
04
Deterministic completeness gates
Both renewal clocks are verified; ex-parte match results are documented; LOC reassessment is scheduled; service-plan elements are checked; any failure blocks release.
05
Specialist release
An LTSS eligibility specialist reviews the exception queue and signs the release. Complex cases (e.g., multiple waivers, disputed eligibility) route to attorney review first.
06
Delivery
You receive the pack: completed forms, evidence log, submission checklist, confirmation receipts, and a dual-track calendar showing the next renewal windows for every client.
The bar we hold
Rigor you can measure.
100%
Specialist-released
No pack ships without a human signature.
5 days
Standard SLA
From complete intake to released pack.
<1%
Critical-defect target
Tracked against a gold-standard pack library.
4
Data-match sources
State data exchange · SSA · prior-year forms · client portal, every applicable file.
Why WaiverGuard
Built to be the most thorough option a home care agency has.
Documentation-complete, by design
The deliverable is completeness itself — every renewal element and data match accounted for or explicitly exception-coded. Nothing is left implicit.
Deterministic, not vibes
The gates that decide completeness are code, not a model's opinion. A drafting error cannot slip past a regulatory requirement.
In its lane, on purpose
We prepare documentation and run data matches as your clerical agent. We never contact the client, give legal advice, or determine eligibility.
Engagement
Flat fee, per released pack. No contingency, ever.
Simple, predictable, and aligned with a documentation standard — not a cut of any Medicaid benefit or recovered payment.
- A free Renewal Gap Scan before you commit — see exactly which clients are at risk.
- One flat monthly monitoring subscription per client plus a flat per-case completion fee; disclosed pass-through data-match fees.
- Optional fixed-fee attorney review for complex eligibility or multi-waiver cases.
- Optional Continuity Add-on for fair-hearing representation support and post-lapse reinstatement exhibits.
FAQ
Questions, answered precisely.
Is WaiverGuard a law firm?
No. WaiverGuard, a service of Your Deputy, Obuke LLC, provides documentation-completeness services. It is not a law firm, does not provide legal advice, and does not represent you in any legal matter. Attorney review is available and recommended for complex eligibility or fair-hearing matters.
Do you contact the client or determine eligibility?
Never. WaiverGuard is not a case manager or eligibility worker and does not contact clients or make eligibility determinations. The agency remains the provider and the party responsible for submitting all renewals and communicating with the state.
What makes a pack 'complete'?
Completeness is defined by CMS guidance and state waiver requirements: both renewal clocks tracked, ex-parte data match attempted, LOC reassessment scheduled, service-plan elements verified, and all forms pre-filled and reviewed. Deterministic gates enforce each one before release.
How fast is it?
The standard SLA is five business days from complete intake to a specialist-released pack. The free Gap Scan is returned much sooner and tells you exactly which clients are approaching a renewal window.
How are you priced?
A flat monthly monitoring subscription per client plus a flat per-case completion fee, plus disclosed pass-through data-match costs. No contingency and no percentage of any Medicaid benefit or recovered payment.
See which clients are at risk before a lapse cuts off billable visits.
Start with a free Renewal Gap Scan. Send your client roster and we'll return a completeness read against CMS guidance and your state waiver requirements.
Documentation-completeness service · not legal advice · the agency submits every renewal.