California home care margin recovery.
You delivered the care and CalEVV recorded it. This is the read-only way to find the visits that never turned into a clean, paid claim, before California's six-month filing clock takes a cut.
Every home care agency in California is really running four columns that are supposed to agree and almost never do.
The hours and units your payer signed off on. In California that is a Medi-Cal waiver or managed-care plan authorization, a Long-Term Care insurance authorization, a VA authorization, or a private-pay care plan. Personal care usually rides on HCPCS T1019, per 15 minutes, with whatever modifiers the payer requires.
The visit that actually happened. Since January 1, 2022, personal care services in California must be captured through electronic visit verification, and home health care since January 1, 2023. California runs a state EVV system called CalEVV, built on the Sandata platform, and also permits certified alternate, open-model EVV systems.
The claim you actually submitted. This is where delivered hours are supposed to become T1019 units on a claim, at the right rate and modifier.
The remittance. What the payer actually allowed and paid, after denials, adjustments, and edits.
The money does not leak in any one column. It leaks in the gaps between them.
- 01Delivered in EVV, never billed
- 02Sliding into the six-month filing penalty
- 03Authorization expiring with hours left
- 04Over-delivery above the authorized ceiling
- 05Unit or modifier mismatch on the claim
Every number here is illustrative and synthetic. It shows the method, not a result, and not a California rate. Reeve reports these as hours, units, and records to price against your own contracted rate sheet.
Why an annual audit or the EMR alone misses this.
The audit is too late for California's clock. A once-a-year review that lands in the spring is looking at visits that, for much of the prior year, are already past the six-month mark. By the time an annual audit flags an unbilled January visit, that visit is in the 50 percent tier or already denied. California's sliding penalty rewards catching the gap in weeks, not quarters. An annual cadence structurally cannot.
The EMR sees its own column, not the reconciliation. Your scheduling and EVV system knows what was delivered. Your billing system knows what was submitted. The remittance knows what was paid. No single one of them sits across all four columns at once and asks whether a verified CalEVV visit ever became a paid T1019 line.
The gap between systems is exactly where the money is, and it is exactly the seam no single system is built to watch. A verified visit that never became a paid claim throws no error inside any one of them, because each one only sees its own column.
A suite adds features inside each column. Reeve does one job across the seams between them.
Plain answers, on the record.
Straight answers about what the Margin Review does, what it does not do, and where your data goes.
- 01What EVV system does California use for personal care?
- California runs a state EVV system called CalEVV, built on the Sandata platform. Personal care services have required EVV since January 1, 2022, and home health care services since January 1, 2023. California also permits certified alternate, open-model EVV systems that pass testing before they connect, so your delivered-care data may live in CalEVV, in Sandata, or in your own certified EVV or EMR that feeds it.
- 02What is the Medi-Cal timely filing deadline?
- Original Medi-Cal claims must be received within six months following the month in which services were rendered. After that, reimbursement slides to 75 percent in months seven through nine, 50 percent in months ten through twelve, and claims are denied after twelve months. That sliding penalty is why unbilled but delivered visits lose value the longer they sit.
- 03Does Reeve quote a dollar recovery for California?
- No, and here is why plainly. Reeve never invents a rate. Dollars come from the rate on your own export or the rate your own remittances actually paid most often. Where Reeve cannot find a rate in your data, the finding still comes to you in hours, units, and the exact California records where the four columns disagree, with the dollar figure left to your own rate sheet. A rate Reeve has not verified is a rate Reeve will not quote.
- 04Is this safe with our client data and PHI?
- The Margin Review runs read-only, in your own browser, on an export you provide. Client names and identifiers are replaced with a coded reference locally before anything is analyzed. Your file is processed in your browser, and no name is written into any output. Reeve reads. It does not write to your EMR, does not file a claim, and does not move money.
- 05What kind of California agency is this built for?
- Non-medical and personal-care home care agencies, typically running on systems like WellSky, AxisCare, or HHAeXchange, with real billing volume across Medi-Cal waiver, managed-care, Long-Term Care insurance, VA, or private-pay authorizations. If you have authorizations, delivered visits, and claims that are supposed to reconcile, the four-column method applies regardless of payer.
- 06What does the Margin Review actually check?
- It reconciles four columns: what a payer authorized, what your EVV shows was delivered, what you billed, and what was paid. It surfaces verified visits that were never billed, visits sliding into California's six-month penalty tiers, authorizations expiring with unused hours, over-delivery above the authorized ceiling, and unit or modifier mismatches on codes like T1019. Every finding comes with the record attached.
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.
Run the free, read-only Margin Review on your own export. It opens in your browser, replaces names with a coded reference locally, and shows you where your authorized, delivered, billed, and paid columns disagree, with the record behind every finding.
- 01
Read-only. Reeve reads your export. It does not write to your EMR, does not file a claim, does not move money.
- 02
Names coded in your browser. Names and identifiers are replaced with a coded reference locally before any math runs.
- 03
No client name, no address, no identifier ever crosses to Reeve.
- 04
The finding is yours, whether or not we ever work together.
Every example figure here is illustrative and synthetic, method rather than results, and California findings are reported in hours, units, and records, never invented dollars.