Arkansas home-care margin recovery: AuthentiCare captures the visit, but the payment lane is the trap.

Arkansas does not make you guess about EVV. The state contracts AuthentiCare through Fiserv and provides it free, and personal care requires it. So the visit-capture problem that plagues other states is mostly handled here. What Arkansas does instead is split the payment lanes in a way that is easy to bill wrong. Most of a member's care can run through a PASSE, the state's full-risk managed-care entity, while the attendant care that agencies actually live on, ARChoices and Independent Choices, is carved out and paid outside the PASSE under state rules. A single member can sit on both sides of that line at once. On a personal-care book, sending a carved-out claim down the managed-care lane is where the money disappears.

This page is about where margin actually leaks in Arkansas, and why catching it means reading your data against the authorization and the correct payment lane rather than trusting that a delivered visit became a paid claim.

EVV is the settled part

Arkansas contracts AuthentiCare through Fiserv and offers it at no cost, and personal care services require it. Agencies that prefer their own software can run a third-party EVV system that meets state and federal requirements, and in that case Fiserv acts as the data aggregator for the alternate system's visits. Either path leads to the same place: the visit has to reach the aggregator before the claim can pay. That part of Arkansas is relatively clean, and it is not usually where agencies lose money.

The PASSE carve-out is where claims go to the wrong place

Arkansas's distinctive risk lives in the payment structure. PASSE is a full-risk managed-care program for members with complex behavioral health or intellectual and developmental disability needs, responsible for nearly all of an enrolled member's services. But the law carves out specific things, and two of them matter enormously for home care: waiver services delivered through ARChoices in Homecare, and the Arkansas Independent Choices program, are excluded from PASSE.

That is the trap. A member is in a PASSE, so the natural instinct is to bill the PASSE. But their ARChoices attendant care does not belong there. It is paid under state rules, in a different lane. The caregiver delivered the visit, AuthentiCare captured it, and the claim still denies because it went to the wrong payer entirely. Nothing about the care was wrong. The routing was.

Where the margin actually leaks in Arkansas

From the way Arkansas pairs settled EVV with a PASSE carve-out, the recoverable losses cluster in a few predictable places:

• PASSE-versus-carve-out routing errors. ARChoices or Independent Choices claims billed to a PASSE instead of the carved-out path. The most Arkansas-specific denial, and easy to repeat across a member's whole episode.
• AuthentiCare exchange gaps. For agencies on a third-party EVV system, visit data that did not reach the Fiserv aggregator cleanly, or arrived with a data element that does not match the claim.
• ARChoices authorization mismatches. Claims that fall outside the approved units or dates on the ARChoices service plan, common when a plan is revised mid-year.
• Independent Choices drift. Self-direction claims that fall outside the participant's authorized allowance or plan, where the participant-managed structure makes the lapse harder to catch.
• Silent underpayments. Claims that pay below the authorized amount. They never show up as a denial, only when payment received is compared to payment expected, line by line.

None of these are visible from the scheduling view. The schedule says the visit happened. AuthentiCare says the caregiver clocked in. The gap appears only when you reconcile the visit record, the authorization, the correct payment lane, and the actual remittance against the claim line.

Why a read-only recovery layer is the right tool for this

Reeve is built for exactly this reconciliation. It sits read-only over whatever EMR and EVV export an agency already runs, whether that is WellSky, AxisCare, HHAeXchange, AlayaCare, or anything else, and compares what was delivered against what was authorized against what was actually paid. For an Arkansas agency, that means lining up the AuthentiCare visit data, the claim lines, the state and ARChoices authorizations, and the payment lane each claim belongs in, then surfacing every place they fail to reconcile: the PASSE-routing errors, the exchange gaps, the authorization mismatches, and the silent underpayments.

Reeve is read-only and neutral across every EMR, so it has no stake in which system you run, and it never writes to your billing workflow without your control. It does not sell scheduling or EVV, so it has no reason to look past a finding that points at a billing module. You get a ranked list of recoverable dollars with the reason attached: the claim sent to the wrong lane, the visit that never synced, the lapsed authorization. The ones still inside the filing window are the ones you can rebill now.

This is the same engine described across the rest of the site. For the mechanics of how EVV gaps become denials, see EVV billing for home care. For the authorization side specifically, see home-care authorization tracking. And for the broader map of revenue loss, see where home-care margin leaks.

What the free Arkansas Margin Teardown does

The way to find out whether PASSE-routing errors and authorization mismatches are draining your margin is to look at a real, de-identified slice of your own data before you spend a dollar. The Margin Teardown is a one-time, read-only read of where margin is leaking in your book: the claims sent down the wrong lane, the AuthentiCare exchange gaps, the ARChoices authorization mismatches, and the underpayments. It is free, and it is yours to keep whether or not you ever work with Reeve. It carries the same 3×-or-free guarantee the rest of the engine does. If Reeve does not surface at least three times its monthly fee in recoverable margin you agree is real, you do not pay.