Compliance and reconciliation sound like the same thing. They're not. A compliance view answers "what percentage of my visits have a good EVV record?" — a number you report. A reconciliation answers a different question: "for every visit my caregivers actually delivered, is there a claim, and did that claim get paid?" One is a score. The other is your bank account.
In Colorado the gap between those two questions is unusually expensive, because the state's EVV enforcement isn't advisory. Since February 1, 2022, a claim requiring EVV that doesn't match a complete visit record in the Sandata aggregator hits a pre-payment review and denies with EOB 3054, "EVV Record Required and Not Found." The care happened. The caregiver was paid. The claim just never found its match. The full Colorado picture — the program structure, the rate environment, the enforcement timeline — is on the Colorado margin-recovery page; this page is the procedure.
The three-way match
Every dollar you're owed depends on three records agreeing about the same visit:
- The authorization — the units the payer approved, for this member, active on this date of service.
- The EVV record — the visit as it exists in the aggregator, complete, with a clock-in and clock-out and the right service code.
- The claim — what you billed, and what the remittance says came back.
Compliance reporting looks at the second record alone. Reconciliation is the join. And the reason it has to be a three-way join rather than two two-way checks is that the failure modes hide in different seams:
- EVV record exists, no claim. You delivered it, you captured it, nobody billed it. This is the quietest and the worst — nothing denies, so nothing shows up on a denial report. There's no alert. The money simply never leaves the building. See unbilled Medicaid revenue for what this looks like at scale.
- Claim exists, no matching EVV record. In Colorado this is EOB 3054 and it denies. At least it's loud.
- Both exist, they disagree. Times, units, or service code don't line up between the visit and the claim line. Denies, or pays wrong. This failure mode exists in every state — see why compliant EVV visits still deny.
- Both exist, they agree, the authorization doesn't cover it. The visit was real and captured, but the auth had lapsed, or the units were already exhausted. This is the authorization-to-claim gap, and Colorado has a specific version of it: HCPF warns that an agency failing to collect EVV across both service types it delivers to the same member — say personal care and homemaker — can burn down the personal-care authorization early while the claims deny. The auth drains and the money doesn't arrive.
What to pull
The reconciliation needs three exports covering the same date range. Pull a full month, not a week — short windows hide the pattern.
From the EVV aggregator: a visit-level export — member ID, date of service, service code, clock-in/clock-out, visit status. You want all visits, including exceptions and incompletes, not just the clean ones. The incompletes are half the story.
From your EMR or scheduling system: the authorization detail — member, service code, effective and end dates, units approved, units consumed.
From billing: the claim register for the same window, plus the remittance advice. The claim register alone tells you what you sent. Only the remittance tells you what happened to it — and the two are not the same document, which is exactly why agencies over-count their revenue.
If any of those three exports is hard to produce, that difficulty is itself a finding. A reconciliation you can't run monthly isn't a control.
How to match
Join on member + date of service + service code. That composite is the key; nothing simpler works, because a member can have two visits on one day under two different codes, and that's precisely the case Colorado's dual-service-type rule punishes.
Then sort the result into four buckets — the four failure modes above — and count both visits and dollars at the current fee schedule in each bucket. Count visits, because that's the operational number your scheduler can act on. Count dollars, because that's the number that decides whether it's worth anyone's Tuesday.
Two cautions on the dollars. First, use the current rate schedule — Colorado applied an across-the-board provider rate reduction effective July 1, 2026, so a spreadsheet built on last year's rates will overstate what you're owed. Second, a dollar in the "delivered, never billed" bucket is only recoverable if the filing window is still open. Which brings up the part that decides everything.
The window is the whole game
An unbilled visit is an asset until the timely filing deadline passes, and a write-off one second later. Nothing about the visit changes. Only the date does.
This is why reconciliation cadence beats reconciliation depth. A perfect quarterly reconciliation that surfaces a gap after the window closed produces a very well-documented loss. A rougher monthly one that catches it at day 40 produces a claim. If you only take one thing from this: run it on a schedule, and know your deadline before you start. Check your filing window.
What "clean" actually looks like
An agency with this under control can answer, for last month, without a project:
- How many delivered visits have no claim, and what are they worth?
- How many claims denied EOB 3054, and is each one a real EVV gap or a matching failure?
- Which members' authorizations are consuming faster than their claims are paying?
- Of everything in those buckets, what's still inside the filing window?
If those four questions take a week to answer, the reconciliation isn't running — it's being reconstructed after the fact, which is a different and much more expensive activity.
None of this requires new software, incidentally. It requires the three exports, a join, and someone whose job it is to look. Plenty of agencies do it in a spreadsheet, and a spreadsheet that runs every month beats a platform that runs when someone remembers. For the broader map of where the money goes, see where home-care margin leaks.
Where Reeve fits
Reeve does this reconciliation read-only. You send the exports; nothing connects to your EMR, nothing writes back, nothing touches a claim. It returns the four buckets, the dollars, and the filing-window status on each one.
The free Margin Review is that reconciliation run once on your last six months, so you can see the buckets before deciding whether they're worth monitoring. If they're not, that's a real answer and it costs you nothing.
You earned this margin. The reconciliation is just making sure you keep it.
A free, de-identified Margin Review reconciles your EVV records, authorizations, claims, and remittances and shows you what slipped. Read-only. Yours to keep.