What does Reeve actually check for a Colorado home care agency?

Reeve reconciles four columns on your own data: what Health First Colorado authorized, what your caregivers delivered in EVV, what you billed, and what the remittance paid or denied. It shows you the records where those disagree, including EVV match denials, authorization gaps, code and unit mismatches, and claims running out of the timely-filing window.

Does my data leave my building?

No. The Margin Review runs in your own browser on an export you provide. Names and identifiers are replaced with a coded reference locally before any reconciliation runs. Reeve reads only. It does not write to your EMR, does not file or edit a claim, and does not move money.

What is EOB 3054 and why do my claims get it?

EOB 3054, EVV Record Required and Not Found, is the Colorado denial for an EVV-required claim that has no matching verified visit. Since February 1, 2022, these claims are denied at a pre-payment review rather than paid. Reeve surfaces the delivered visits that failed to match so they can be corrected and resubmitted.

How long do I have to fix a denied Colorado Medicaid claim?

Health First Colorado allows 365 days from the date of service to file, even when the first result is a denial, and then requires a resubmission every 60 days after that to keep the claim inside the timely-filing window. Reeve ranks your findings by how close each date of service is to that edge.

Which Colorado services does the EVV requirement cover?

EVV-required services in Colorado include Personal Care, Homemaker, Home Health, Consumer Directed Attendant Support Services (CDASS), In-Home Support Services (IHSS), and Respite and Youth Day. Colorado uses a hybrid model on the Sandata aggregator, so whether you use the state Sandata solution or a Provider Choice system, the visit still has to match the claim.

Are the dollar figures Reeve shows real recoveries?

No. This page deliberately shows findings in hours, units, and records rather than dollars, because your own export may not carry a rate for every code. On your real export, Reeve prices findings off the rate on your own export or the rate your own remittances actually paid most often, and labels anchored figures plainly.

Do I have to sign anything or install software?

No install and no signature to try it. The Margin Review is self-serve and read-only. You provide an export, it runs in your browser, and you keep the findings whether or not we ever work together.

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.

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The four numbers

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.

Authorized

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.

Delivered

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.

Billed

What went out on the claim: the code, the modifier, the units, the date of service.

Paid

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.

01
The 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.
02
The authorization gap. Delivered hours past the authorized span or unit ceiling. Reeve caps recoverable at what was authorized and surfaces the overage separately.
03
Timely-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.
04
Code 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.

Illustrative findings

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.

Finding A

EVV denial never reworked

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.

Finding B

Delivered under the auth, never billed

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.

Finding C

Timely-filing clock almost out

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.

Finding D

Exemption paperwork gap

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.

Finding E

Modifier mismatch underpayment

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.

The blind spot

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.

Questions

Plain answers, on the record.

What a Colorado owner asks before running a review, answered straight.

01 What does Reeve actually check for a Colorado home care agency?: Reeve reconciles four columns on your own data: what Health First Colorado authorized, what your caregivers delivered in EVV, what you billed, and what the remittance paid or denied. It shows you the records where those disagree, including EVV match denials, authorization gaps, code and unit mismatches, and claims running out of the timely-filing window.
02 Does my data leave my building?: No. The Margin Review runs in your own browser on an export you provide. Names and identifiers are replaced with a coded reference locally before any reconciliation runs. Reeve reads only. It does not write to your EMR, does not file or edit a claim, and does not move money.
03 What is EOB 3054 and why do my claims get it?: EOB 3054, EVV Record Required and Not Found, is the Colorado denial for an EVV-required claim that has no matching verified visit. Since February 1, 2022, these claims are denied at a pre-payment review rather than paid. Reeve surfaces the delivered visits that failed to match so they can be corrected and resubmitted.
04 How long do I have to fix a denied Colorado Medicaid claim?: Health First Colorado allows 365 days from the date of service to file, even when the first result is a denial, and then requires a resubmission every 60 days after that to keep the claim inside the timely-filing window. Reeve ranks your findings by how close each date of service is to that edge.
05 Which Colorado services does the EVV requirement cover?: EVV-required services in Colorado include Personal Care, Homemaker, Home Health, Consumer Directed Attendant Support Services (CDASS), In-Home Support Services (IHSS), and Respite and Youth Day. Colorado uses a hybrid model on the Sandata aggregator, so whether you use the state Sandata solution or a Provider Choice system, the visit still has to match the claim.
06 Are the dollar figures Reeve shows real recoveries?: No. This page deliberately shows findings in hours, units, and records rather than dollars, because your own export may not carry a rate for every code. On your real export, Reeve prices findings off the rate on your own export or the rate your own remittances actually paid most often, and labels anchored figures plainly.
07 Do I have to sign anything or install software?: No install and no signature to try it. The Margin Review is self-serve and read-only. You provide an export, it runs in your browser, and you keep the findings whether or not we ever work together.

Two lanes, priced separately

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.

Margin Review

Free

One pass over your own export, in your browser. The findings are yours to keep, with no obligation.

Collect

$750 per branch per month

The recovery lane. Care you delivered and never billed, units short of what was authorized, lines paid under the published rate.

Cover

$1,000 per branch per month

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.

Start with a Margin 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.

Start my free Margin Review

01
Read-only. Reeve reads your data. It does not write to your EMR, does not file a claim, does not move money.
02
Names coded locally. Names and identifiers are replaced with a coded reference unique to your agency in your own browser before any reconciliation runs.
03
No client name, no address, no identifier is sent anywhere.
04
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.