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Florida home care billing has four columns that should match. Reeve shows you where they do not.

Authorized. Delivered. Billed. Paid. On a clean visit, those four numbers line up. In real Florida agencies they drift apart, quietly, one lapsed authorization and one unconfirmed EVV visit at a time. Reeve is a free, read-only Margin Review that reads an export you already have and shows you the exact records where the four columns disagree, with the visit attached. You keep the money you already earned.

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The four numbers

You did the work. A caregiver drove out, delivered the hours, clocked the visit. Somewhere between that visit and the deposit, Florida gives the money four chances to slip. Reeve reads all four and lines them up.

Authorized

Most Florida personal care runs through Statewide Medicaid Managed Care, including the Long-Term Care program, where a managed-care plan authorizes a set number of units over a span of dates. A smaller slice runs fee-for-service through AHCA. Either way, the authorization is a ceiling and a clock. When it lapses or runs out of units mid-month, every hour past that line is care you deliver and cannot bill clean.

Delivered

This is your schedule and your visit log, the hours a caregiver actually worked. As of October 1, 2024, AHCA moved fee-for-service home health, private duty nursing, and personal care onto an Open Vendor Model with HHAeXchange as the state EVV system. Most major SMMC plans run EVV through HHAeXchange too. A visit that is delivered but never confirmed in EVV is a visit your biller cannot safely put on a claim.

Billed

What actually went out on a claim, to the plan or to Medicaid. The gap between delivered and billed is the one nobody is assigned to watch: the visit that got stuck in a handoff, the unit that fell off because the auth had already lapsed, the EVV exception that was never reconciled before the biller closed the batch.

Paid

What came back. A billed line can still be denied, short-paid, or reduced to the authorized ceiling. And in Florida the clock is real: fee-for-service claims must be received within 12 months of the date of service, and SMMC plans set their own, often much shorter, filing windows. A visit you find in month eleven is worth chasing. A visit you find in month thirteen is gone.

The money does not leak in any one column. It leaks in the gaps between them.

  • 01
    EVV confirmed but never billed, delivered hours sitting between delivered and paid.
  • 02
    Delivered past the authorization ceiling, only the pre-lapse units are clean to bill.
  • 03
    Timely-filing risk aging toward the 12-month wall and the shorter plan deadlines.
  • 04
    EVV exception drift, visits delivered but never carried through to a clean claim.
Illustrative findings

Every number is illustrative and synthetic. Findings are counted in hours, units, and records to check against your own rate sheet, never in dollars Reeve made up.

Finding A
EVV confirmed but never billed
41 visits across a quarter show a matching EVV confirmation in the aggregator but no corresponding paid line. Total: about 96 delivered hours sitting in the gap between delivered and paid. Records attached, sorted by date of service so you can see which ones are closest to the filing wall.
Finding B
Delivered past the authorization ceiling
For 7 members, delivered units exceed authorized units inside the same span. Reeve keeps two things apart: units delivered while the authorization was still open and billable, versus units delivered after it lapsed or maxed out. Only the first bucket is clean to bill. The second is a note to your intake and reauthorization process, not a recovery. Reeve never blends the two.
Finding C
Timely-filing risk queue
18 unbilled or denied visits are within 60 days of a filing or correction deadline. This is not a dollar finding, it is a clock finding. It ranks the records by days remaining so your biller works the ones about to expire first, before the window closes and the decision gets made for you.
Finding D
EVV exception drift
Across one branch, 23 visits are flagged as delivered on the schedule but show no clean matched EVV confirmation carried through to a claim. Each one is a record to reconcile in the aggregator before it can be billed safely. Left alone, these are the visits that either never bill or bill in a way that will not hold up.
The blind spot

Why an annual audit or the EMR alone misses this.

01

Your EMR is very good at the visit that goes right. It schedules it, captures the EVV clock-in, and drops it in the billing queue. What it does not do is stand at the seam between systems and ask whether the confirmed visit ever became a paid line, and whether the clock is about to run out on the ones that did not.

02

The EVV-to-claim gap is a handoff, not a feature. In an Open Vendor Model, a visit can be confirmed in HHAeXchange and still never reconcile onto a clean claim, or a plan can pay it short, and nothing in the daily workflow forces those two records back together. The confirmation lives in one system. The payment lives in another. The missing money lives in the space between.

03

The 12-month wall, and the shorter managed-care ones, turn a slow leak into a permanent loss. An annual audit finds the problem once a year, which for a chunk of your visits is already too late. A leak you catch in month thirteen is not a finding, it is a write-off. Reeve is built to surface the record while there is still time to act on it.

A yearly look tells you what happened. Reeve shows you what is still recoverable.

Questions

Plain answers, on the record.

How Reeve handles a Florida book, in your own words.

01
Does Reeve work with Florida Medicaid managed care plans, not just fee-for-service?
Yes, with one difference worth knowing before you upload. Reeve reads the export you provide, so the reconciliation is authorized versus delivered versus billed versus paid whether your volume runs through SMMC and SMMC LTC plans like Sunshine Health, Molina, Humana, or Simply, or through fee-for-service AHCA. The difference is the dollar. Fee-for-service rows are priced against the published AHCA schedule. Plan rows come back in hours, units, and record counts with no dollar attached, because Florida does not publish a rate the plans are bound to pay and Reeve will not put your contract rate in your mouth. You price those against your own contract.
02
How does Reeve handle EVV, and do I need to be on HHAeXchange?
Reeve reads your data read-only. It does not connect to, write to, or change anything in HHAeXchange or any EVV system. It simply reconciles your delivered and EVV-confirmed visits against what was billed and paid, and shows you the visits that never made it across. It works whether you use the state HHAeXchange system or a third-party EVV that integrates with it.
03
Will Reeve tell me the dollar amount I can recover in Florida?
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 Florida 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.
04
Is my client data safe? What actually leaves my building?
Nothing with a name on it. The Margin Review runs in your own browser on an export you provide, and it replaces names with a coded reference locally before any analysis. Client names, addresses, and identifiers stay on your machine. Reeve reads, it does not write, it does not file a claim, and it does not move money.
05
What is the timely-filing deadline I should worry about in Florida?
For fee-for-service, a clean claim must be received within 12 months of the date of service. SMMC managed-care plans set their own filing and correction deadlines in their provider contracts, and those are frequently much shorter, so check each plan. Reeve ranks unbilled and denied records by how close they are to a deadline so the ones about to expire get worked first.
06
What do I need to try it, and how long does it take?
An export from your EMR or billing system, the kind you can already pull. You run the Margin Review yourself in your browser. There is no install, no integration, no IT project, and no data leaves your building to get started.
07
Does Reeve replace my biller or my EMR?
No. Reeve does not bill, post, or file anything. It hands your biller a ranked worklist of specific records to check, with the visit attached, so the people who already do your billing can act on it. It extends what you have. It does not replace it.
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.

You already delivered the care. The Margin Review just shows you the part that never turned into a clean, paid claim, on your Florida book, in your own browser, in about the time it takes to pull an export. You run it. You keep the findings whether or not we ever work together.

Start my free Margin Review
  • 01

    Read-only. Reeve reads your export. It does not write, does not file a claim, does not move money.

  • 02

    Runs in your browser. The review runs on your machine, on data you provide. There is no upload of a named record to get started.

  • 03

    Names coded locally. Names, addresses, and identifiers are replaced with a coded reference unique to your agency on your side before any analysis. Your file is processed in your browser, and no name is written into any output.

  • 04

    Yours to keep. The findings are yours. No obligation, no contract to look.

Every number on this page is labeled illustrative and synthetic because none of it comes from a real agency.