Arkansas home care margin recovery.
You delivered the visits.
In Arkansas, EVV is mandatory for personal care and a claim that does not reconcile to a matching accepted visit denies, and the filing clock is 365 days. Reeve reads your own billing export, right in your browser, and shows you the authorized, delivered, billed, and paid columns side by side, so the gaps have a record attached.
Every dollar of personal care in Arkansas passes through four states of being, and they do not always agree.
The payer approved a number of units. In Arkansas that is a Medicaid State Plan Personal Care Services authorization, or an ARChoices in Homecare waiver authorization for attendant care, administered by DHS and the Division of Medical Services. The clock and the ceiling both live here.
The people who deliver the care worked the visit and it landed in Electronic Visit Verification. Arkansas runs an open EVV model, so providers may use their own EVV, but the visit still has to reach the state's EVV record for the claim to stand up. Either way, the visit becomes an accepted EVV transaction, or it does not.
A claim went out to Arkansas Medicaid with a Medicaid ID, date of service, NPI, a HCPCS code, and a unit count. Personal care rides on T1019 per 15 minutes, with T1020 available as a per diem alternative. Units are counted in quarter hours, so small miscounts add up fast.
The claim matched, cleared its other edits, and remitted. Or it hit a mismatch and denied.
The leaks live in the gaps between those four columns, and Arkansas has one plain rule that turns a gap into lost money: EVV is mandatory for personal care, and a claim without a matching accepted EVV visit does not pay, no matter how much care was delivered, all inside a 365-day filing window.
- 01Delivered but never billed
- 02EVV visit not reconciled to the state's EVV record
- 03Billed fewer units than the visit shows
- 04Denied for a service code or unit mismatch
- 05Aged past the 365-day filing window
Every number is illustrative and synthetic. Because your own export may not carry a rate for every code, findings on this page are expressed in hours, units, and records to check against your own rate sheet, never in dollars Reeve made up.
12 claims paid clean this quarter where the accepted EVV visit shows more delivered quarter-hour units than the claim billed. Example: a visit accepted for 12 units of T1019, claim billed 10. The claim matched and paid, so nothing flagged, but 2 units per visit across 12 visits is 24 units of delivered care that never turned into a claim line. Records attached, ready to check against your contracted rate.
7 denied claim lines where the underlying visit is in your EVV vendor but did not reconcile to the state's EVV record at claim time. Example: the visit fired from a proprietary system but never posted to the state. Five of the seven are still workable today. The other two are past the clock.
3 clients where delivered and accepted EVV units exceed the authorized units on file under PCS or ARChoices. This is not recoverable, and Reeve will not pretend it is. It surfaces separately as over-delivery, care the people who deliver it gave that was never authorized, so you can see the exposure and fix the auth going forward rather than quote it as money owed.
17 delivered-and-accepted EVV visits with no matching claim found in the export, sorted by date of service against the 365-day clock. 10 are still inside the window and billable now. 4 are inside a resubmission window on a prior denial, workable if reworked promptly. 3 are past 365 and gone. The list is ranked by days remaining, so the billable ones are at the top.
5 visits where the aide identifier on the accepted EVV transaction does not line up with the provider identifier on the claim. Each one is a denial waiting to happen or one that already did, with the specific visit and claim record paired so your biller can see exactly which field to correct.
Why an annual audit or the EMR alone misses this.
A once-a-year audit looks back over twelve months. In Arkansas the money has a 365-day clock. By the time an annual review names a denied line, the filing window may be closing and the reason lost. A once-a-year audit finds the denied line after the clock on it has run.
The EMR is not built to catch it either. Your EMR knows what it billed. Your EVV vendor and the state's EVV record know what visit was accepted. The remittance knows what paid. Those three live in three places, and the mismatch is in the seam between them. A clean match shows green in your billing screen even when the visit carried more units than the claim, because the claim matched the units it declared, not the units delivered.
The gap only shows when you put the accepted EVV transaction, the claim, and the remittance in the same view and read them together. That is the one thing Reeve does. It reads across the seam.
That is what Reeve reads for in Arkansas: what the state's EVV record accepted, what the authorization allowed, what you billed, and what actually paid, read against each other rather than audited for rate.
Plain answers, on the record.
Straight answers on how the Arkansas Margin Review works, what it touches, and what it will not claim.
Collect is money you never captured. Cover is money a payer can still take back.
Reeve reports the two separately and never adds them together, because only one of them is yours to go and get. The Margin Review reads both on your own export and costs nothing.
One pass over your own export, in your browser. The findings are yours to keep, with no obligation.
The recovery lane. Care you delivered and never billed, units short of what was authorized, lines paid under the published rate.
Everything in Collect, plus the exposure lane. Retired codes, authorizations at the end of their period, care delivered past what was approved.
Month to month, no annual contract. Read-only in every tier. Run the free review.
Try it yourself. Run a free Margin Review.
No sales call. No account to create. Export your data, open the review in your browser, and see your authorized, delivered, billed, and paid columns lined up in about the time it takes to read this page.
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Read-only. Reeve reads your export and does not write to your EMR, does not file a claim, does not move money.
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Names coded locally. Names and member identifiers are replaced with a coded reference in your browser before any analysis runs.
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Your file is processed in your browser, and no name is written into any output. No upload of identified data, no server holding your client list.
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Yours to keep. The findings are yours whether or not we ever work together.
Reeve reads your billing read-only and replaces its names with coded references before any math runs. Every example figure is illustrative and synthetic, method rather than results, and Reeve makes no guarantee of recovery.