Colorado home care margin recovery, starting with a free read-only Margin Review.
You are already delivering the care.
In Colorado, the money leaks in the gap between what a payer authorized, what your caregivers delivered, what you billed, and what actually got paid. Reeve reads that gap on an export you provide, in your own browser, and shows you the records where the four numbers disagree. Your file is processed in your browser, and no name is written into any output.
Reeve does one job. It lines up four columns that almost never get looked at side by side, and it points at the rows where they do not match.
What Health First Colorado, the state Medicaid program run by the Department of Health Care Policy and Financing, approved on the prior authorization: the units, the span of dates, the procedure code.
What your caregivers actually worked, captured in Electronic Visit Verification. Colorado runs a hybrid EVV model on the Sandata aggregator. Whether you are on the state Sandata system or your own Provider Choice system, the visit still has to land and match.
What went out on the claim: the code, the modifier, the units, the date of service.
What the remittance actually returned, and what it denied.
The money does not leak in any one column. It leaks in the gaps between them.
- 01The EVV to claim gap. Since February 1, 2022, an unmatched visit comes back denied as EOB 3054, EVV Record Required and Not Found. A missing exemption comes back as EOB 3056.
- 02The authorization gap. Delivered hours past the authorized span or unit ceiling. Reeve caps recoverable at what was authorized and surfaces the overage separately.
- 03Timely-filing risk. Colorado gives 365 days from the date of service, then requires a resubmission every 60 days to hold the claim inside the window.
- 04Code and modifier mismatch. Personal care commonly bills under T1019 and homemaker under S5130, both per 15 minutes. A wrong unit or modifier is a quiet underpayment.
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. On a real run, dollars come from the rate on your own export or the rate your own remittances actually paid most often, never from a rate Reeve made up.
14 personal care visits (T1019) came back as EOB 3054, EVV Record Required and Not Found. The visits exist in EVV but did not match the claim line. Delivered and authorized, denied on a match failure, never resubmitted. Reported as 14 denied claim lines to rework, each pointed back at its source record. On your own export Reeve prices them off your rate, never off a rate it made up.
For one client, the authorization covered 120 units in the month. EVV shows 120 delivered. The claim billed 96. 24 authorized-and-delivered units, 6 hours, never made it onto a claim. Reeve caps recoverable at the authorized 120 and reports the 24-unit gap for your biller to price against your own rate sheet.
9 denied claims carry dates of service between 330 and 360 days old. They are inside the 365-day window today and will fall out within weeks unless resubmitted. Reeve ranks these first and reports the days remaining on each, so the ones closest to lapsing get worked first.
6 visits denied as EOB 3056, EVV Exemption Required, Not Found. The care was delivered but the exemption was not on file at adjudication. This is a fix-the-record-and-resubmit item, not a lost cause. Reported as 6 records to correct and resubmit.
A block of homemaker visits (S5130) billed at a unit count that does not reconcile to EVV delivered time. The pattern points at a rounding or modifier handling issue quietly shorting the claim. Reported as a records-and-units finding for your biller to confirm.
Why an annual audit or the EMR alone misses this.
Your EMR is very good at helping you deliver care and drop a claim. It is not built to sit across authorization, EVV, the claim, and the remittance at the same time and argue with itself. Nobody is holding all four next to each other on a Tuesday.
An annual audit has a worse problem: timing. In Colorado you have 365 days from the date of service, and after a denial you have to resubmit every 60 days to keep the claim alive. A leak a year-end audit finds in month eleven may already be dead.
The EVV to claim gap is the sharpest edge, because since February 2022 an unmatched visit is not a warning, it is a denial. Reeve is built to look at exactly the seam the EMR and the audit both skip, and to look at it now rather than in eleven months.
Reeve reads across the seam the other tools cannot see.
Plain answers, on the record.
What a Colorado owner asks before running a review, answered straight.
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 install. No signature. No sales call to get the number. You bring an export, Reeve shows you where the four columns disagree, and the findings are yours to keep.
- 01
Read-only. Reeve reads your data. It does not write to your EMR, does not file a claim, does not move money.
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Names coded locally. Names and identifiers are replaced with a coded reference unique to your agency in your own browser before any reconciliation runs.
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No client name, no address, no identifier is sent anywhere.
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Honest by default. Illustrative numbers are labeled illustrative. Reeve never invents a rate; dollars come from the rate on your own export or the rate your own remittances actually paid most often.
Any dollar figures in examples are illustrative and synthetic, method rather than results.