Unbilled visits: why they cost your agency twice.
A denied claim is loud. Someone in the office sees it, works it, or lets it age. An authorized visit that was never billed is the opposite. You paid the caregiver, you collected nothing, and no report anywhere tells you it happened. That is why unbilled visits are usually the largest recoverable line on a Margin Review.
The double hit
Every unbilled visit takes cash out twice. Once when payroll runs, wages, taxes, mileage, and again when the payer never sends a remittance for care that would have been paid at contract rate. There is no denial, no aging bucket, no follow-up queue. The visit is simply absent from the revenue side of the books.
Why it happens
It is almost never clinical. It is a handoff failure between the schedule, the caregiver record, the plan of care, and the claim.
- ›Authorizations still pending when the visit was delivered.
- ›Plans of care unsigned or physician orders missing on the date of service.
- ›Time entries late, missing, or stuck in a review status.
- ›Multi-branch or multi-payer complexity where no single owner reconciles.
Why nobody catches it
Standard AR reports show submitted claims. If a claim was never created, it never enters the report. There is no remittance line to reject and no denial to route. The visit simply does not exist to the revenue cycle system, so it stays invisible while the filing deadline runs out.
The most recoverable leak there is
Unlike a denial, an unbilled visit is not a dispute. The authorization exists, the visit exists in EVV, the delivery is documented, and the payer has already agreed to a rate. The only thing missing is the claim itself. Recovery is only limited by the filing window, which is why speed matters more than volume when you find them.
How to find yours
- 01Reconcile at line levelAuthorizations vs EVV vs claims
For each authorized visit, ask: is there a matching EVV record, and is there a matching claim line? Missing claim, matching auth and EVV, is the definition of unbilled.
- 02Prioritize by deadlineFiling window, not dollar size
Sort candidates by days remaining in the payer's timely filing window. Small amounts nearing expiration outrank large amounts with room to breathe.
- 03Run on a rolling 90 daysContinuous, not annual
A rolling 90-day cadence catches unbilled visits while they are still recoverable and keeps the queue small enough to actually work.
Plain answers, on the record.
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.
See your unbilled visits, ranked by deadline.
Export one closed month and the review isolates every authorized, delivered visit with no matching claim, sorted by days left in the filing window.