Can Reeve find money in my Medicare PDGM periods?

Not from units. A PDGM period is episodic payment, and Reeve's arithmetic is unit arithmetic: authorized units against delivered units against billed units, capped by the authorization ceiling. There is no defensible conversion between the two, so Reeve classifies Medicare rows out of the unit detectors before detection and prices them from the published CY2026 tables instead. LUPA conversion and the value based purchasing adjustment are treated the same way: the LUPA difference is priced from the published per visit rates, and the value based adjustment is held by the contractor, so Reeve prices before it and says so. Late notices of admission, LUPA conversions, and case mix coding are real problems. Since r189 the late notice of admission is one Reeve does read: it reports periods whose payment was cut because the NOA was accepted outside the five day window, as a liability you already carry rather than as money to collect. That check turns on when your drop carries a period export carrying the date the admission notice was accepted, and it will read that export on its own. LUPA conversion is priced from the published per visit rates and case mix coding is read from the paid HIPPS, so a group outside the published table is named rather than guessed.

So what does it actually read on a home health agency?

The unit billed services alongside the Medicare book: Medicaid personal care and waiver attendant hours, private duty nursing, and hourly contracted work. If a payer approved a number of hours or quarter hour units for a member across a dated span, that is the shape Reeve reconciles, and it is usually the least supervised revenue in the building.

How do I know Medicare rows were excluded rather than overlooked?

The coverage panel on the report names every check that ran, every check that could not run, and how many rows each one set aside by payer. An exclusion is printed. It is not something you have to deduce from an empty results list.

Which setting should I pick when I run the review?

If the unit billed portion of your book is Medicaid home care, pick Home care rather than Home health. That is the setting the unit checks are calibrated for. The setup screen states this before you choose a file, so the choice is made with the limitation in front of you.

Does my data leave my building?

No. Reeve runs in your own browser on an export you provide. Patient names, medical record numbers, and other identifiers are replaced with a coded reference locally before any analysis happens. Your file is processed in your browser, and no name is written into any output.

Will it fix or refile anything for me?

No, and that is deliberate. It does not write, does not file a claim, does not move money. It shows the gap and the record behind it, and the correcting stays with the people licensed and authorized to do it.

What does it cost, and what is the catch?

The first review is free and carries no obligation. Whatever it finds is yours to work regardless of what you decide afterward.

Your Medicare book has a whole industry watching it. The hourly book next to it has your billing clerk.

Reeve prices programs that authorize units and bill units.

Where a payer pays a per diem or an episode instead of a unit, Reeve puts no dollar on the line from unit arithmetic and does not estimate one. Medicare fee for service is the one exception, and it is priced from the tables CMS published rather than from unit arithmetic: the CY2026 home health period rates, case mix weights and LUPA thresholds, and the FY2026 hospice per diems, labor shares and aggregate cap. The Medicare home health episode is paid as a 30 day period, so a PDGM period and a LUPA conversion carry no figure from unit arithmetic. They are priced from the CY2026 case mix weights, LUPA thresholds, per visit rates and wage index CMS published, and from nothing else. The notice of admission is the one episode mechanic Reeve does read, as a liability you already carry rather than as money to collect, when the drop carries a period export carrying the date the admission notice was accepted. We would rather lose the visit than sell you a number we cannot defend, so that limit is the first thing on the page instead of a footnote under it. What Reeve does read is the part of a home health agency nobody has built a dashboard for: Medicaid personal care and waiver attendant hours, private duty nursing, and any line a payer authorizes in hours or quarter hours and you bill in units. That book is authorized, delivered, billed, and paid in four different systems, and it is nobody's full time job. Reeve runs in your own browser on an export you provide, replaces every patient identifier with a coded reference before a single figure is computed, and returns the rows where those four columns disagree.

Run the review

The boundary, stated first

We price units, and we price Medicare from what CMS published. The Medicare episode is not units.

Out of scope, said plainly

The 30 day PDGM period, the case mix HIPPS, and the LUPA threshold are episode mechanics, and Reeve prices them only from the published CY2026 tables for a Medicare fee for service period, never from unit arithmetic. A period with no paid HIPPS, a group outside the 432 published, a county that does not resolve to a wage area, or a date in a rule year that is not final is refused by name. The notice of admission reduction is the exception: Reeve reports it, at the amount the payer's own reduction implies, when the drop carries a period export carrying the date the admission notice was accepted. There is no verified arithmetic that turns an episode into an authorized unit ceiling, and Reeve will not manufacture one. Those payers are classified and set aside before any check runs, which means no finding, no dollar, and no implication that they were reviewed and found clean.

In scope and reconciled

The unit billed services running beside the Medicare book. Attendant and personal care hours under a state Medicaid program or a waiver, private duty nursing, and contracted hourly work. Authorized in units across a dated span, delivered on a visit record, billed on a claim line, settled on a remittance.

Priced only where the rate is verified

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 comes to you in hours, units, and the exact records.

Reported at zero

Rows Reeve refuses to price still reach you. Clawback exposure, expired authorizations, rate variance, and every row whose payer class falls outside the rules Reeve holds are listed with the record attached and excluded from the recoverable total by construction, not by convention.

Payer classification happens before detection, not after it. Each check reports the rows it examined and the rows it declined, so an exclusion is a line you can read rather than an absence you have to infer. If the unit billed part of your book is a Medicaid home care book, run the review with Home care selected, because that is where the unit checks are calibrated to run. Reeve reads period rows repeated per visit, adjustment and cancel claims, notice rows, expected payment columns, missed visits and summary tabs. It counts each period once, nets labelled claim activity, keeps estimates out of paid amounts, excludes visits that were not delivered and skips summary tabs.

The four numbers

Take one attendant hour on the Medicaid side of your agency and follow it. It passes through four records, held in four places, owned by three different people. Reeve puts them in one row.

Authorized

The units a state program or a managed care plan approved for a member, and the dated span they are good for. This is the ceiling every other column is measured against, and it is usually the column your billing system knows least about.

Delivered

What actually happened in the home. The clock in, the clock out, the duration, and where your state requires electronic visit verification on the service, the transaction the aggregator accepted.

Billed

The claim line that left the building. Code, modifiers, units, dates, and the authorization it was filed against.

Paid

The remittance. Not just whether a line paid, but at what rate, with which adjustment reason, and whether the balance left behind is still inside the window to work.

Each column looks correct when you read it alone. The money is only visible in the gap between two of them.

01
Delivered but never billed. The hour was worked, verified, and documented, and no claim line was ever created for it. There is no denial to find because there was never a claim, which is why a denial report can be spotless while the hour is gone.
02
Authorized but never used. A span closed with approved units left on it. Nobody is notified when an authorization expires with room to spare.
03
Billed past the ceiling. Delivery beyond the approved units. That is not a collection opportunity, it is exposure, and Reeve reports it that way and at zero.
04
Paid short or denied and still open. A line that came back below the rate your own remittances usually pay for that code, or denied with time left on the filing calendar to correct it.
05
Payer unclassified. A row Reeve cannot place under a rule set it can defend. Counted, named, and excluded, so the report is never cleaner than the file.

Where the margin leaks

These are the patterns Reeve looks for on the unit billed portion of a home health book. No dollar figures appear here, because an invented example number teaches you nothing about your own agency and every figure in the actual review comes off your own export.

Finding A

A verified hour with no claim line behind it

The visit record and the claim file disagree for one member, one code, one date. Reeve pairs the delivered record to the missing line and caps any figure at what the authorization permitted, so the estimate can never exceed the ceiling the payer wrote.

Finding B

An authorization span that closed with units on it

Reeve reports the span, the approved units, and the units actually billed against it. Some of those gaps are real care that was never scheduled. Some are hours that were worked and lost on the way to a claim, and this is how you tell them apart.

Finding C

Delivery beyond the approved units

Hours billed past the ceiling on the authorization. Reeve shows the authorization and the delivered record together, on the exposure list, before an audit finds them first.

Finding D

A denied balance the filing calendar still allows

Denied lines are ranked by how much time is left to work them. Where Reeve has a primary source for your state window it reads the deadline from that source. Where it does not, the row is marked indeterminate and no dollar is attached to it.

Finding E

Lines paid under your own prevailing rate

The benchmark is your own paid history for that code, not a published table, and Reeve refuses to benchmark a code that does not have enough paid lines behind it to be meaningful.

The blind spot

Why the hourly book is the one that goes unwatched.

It is not where the revenue is, so it is not where the people are. Your best biller works the Medicare side, because that is where a mistake costs thousands in one period. The Medicaid attendant hours get whatever attention is left over, and the errors there are small, frequent, and individually forgettable.

The systems are not built for the comparison. An EMR is very good at the column it owns. It knows what was scheduled and documented. It does not sit next to the remittance and ask, line by line, whether the hour that was worked ever produced a dollar that arrived.

The failure mode is an absence, and absences do not raise alerts. An unbilled hour produces no denial, no rejection, and no variance. It produces nothing at all, and nothing is exactly what a report built to list problems will show you.

Reeve does not replace your biller, your coder, or your EMR, and it does not go anywhere near your Medicare claims. It reads an export you already know how to produce, replaces its names with coded references on your machine, and lines the four columns up on the part of the book nobody has the hours to line up by hand.

Exposure

What you may have to give back, found while it is still fixable.

Money you can collect and money you may have to return are two different numbers, and Reeve never adds them together. Exposure is the second one, and Reeve surfaces it before the payer finds it.

01
Care delivered past what the authorization approved, with the authorization and the delivered record side by side.
02
Service and attendance records that failed the payer's visit verification system, flagged with the reason they failed.
03
Visits and days missing a signature or a required timestamp.
04
Conflicts inside one person's own delivery day: two visits by the same person whose recorded times overlap, and hours that cannot both be true.

Exposure never enters the recoverable total. It sits on its own line, with its own figure, attached to the record it came from. What you do about it is yours to decide.

Questions

Plain answers, on the record.

What Reeve reads on a home health book, what it refuses to touch, and what happens to your file.

: Not from units. A PDGM period is episodic payment, and Reeve's arithmetic is unit arithmetic: authorized units against delivered units against billed units, capped by the authorization ceiling. There is no defensible conversion between the two, so Reeve classifies Medicare rows out of the unit detectors before detection and prices them from the published CY2026 tables instead. LUPA conversion and the value based purchasing adjustment are treated the same way: the LUPA difference is priced from the published per visit rates, and the value based adjustment is held by the contractor, so Reeve prices before it and says so. Late notices of admission, LUPA conversions, and case mix coding are real problems. Since r189 the late notice of admission is one Reeve does read: it reports periods whose payment was cut because the NOA was accepted outside the five day window, as a liability you already carry rather than as money to collect. That check turns on when your drop carries a period export carrying the date the admission notice was accepted, and it will read that export on its own. LUPA conversion is priced from the published per visit rates and case mix coding is read from the paid HIPPS, so a group outside the published table is named rather than guessed.
: The unit billed services alongside the Medicare book: Medicaid personal care and waiver attendant hours, private duty nursing, and hourly contracted work. If a payer approved a number of hours or quarter hour units for a member across a dated span, that is the shape Reeve reconciles, and it is usually the least supervised revenue in the building.
: The coverage panel on the report names every check that ran, every check that could not run, and how many rows each one set aside by payer. An exclusion is printed. It is not something you have to deduce from an empty results list.
: If the unit billed portion of your book is Medicaid home care, pick Home care rather than Home health. That is the setting the unit checks are calibrated for. The setup screen states this before you choose a file, so the choice is made with the limitation in front of you.
: No. Reeve runs in your own browser on an export you provide. Patient names, medical record numbers, and other identifiers are replaced with a coded reference locally before any analysis happens. Your file is processed in your browser, and no name is written into any output.
: No, and that is deliberate. It does not write, does not file a claim, does not move money. It shows the gap and the record behind it, and the correcting stays with the people licensed and authorized to do it.
: The first review is free and carries no obligation. Whatever it finds is yours to work regardless of what you decide afterward.

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.

The run

Run it where the units are. We leave the episode alone.

Pull an export covering the unit billed side of your agency, open the review, and read the four columns in one place. The Medicare book is excluded before the first check runs, and the report tells you so rather than leaving you to wonder.

Run the review Or book time with a person

01
Read-only. Reeve reads your records and writes to nothing.
02
Names coded locally. Names and medical record numbers are replaced with a coded reference unique to your agency in your browser before anything is analyzed.
03
Scope declared up front. Episodic payers are named as out of scope before the run rather than after it.
04
No obligation. See the actual scan counts on your own book and decide for yourself.

There are no illustrative dollar figures on this page, because the only number worth reading is the one your own file produces. Reeve is read-only: it does not file, does not appeal, does not write to an EMR, does not move money.