Home health does not bill visits, it bills 30-day PDGM periods, and that changes where the money leaks. A visit count that lands just under a LUPA threshold repays the whole period at a per-visit rate. A period timed or grouped wrong pays under a different case-mix. OASIS that does not match the claim invites review. None of it shows up claim by claim. Reeve reads the periods against what was actually paid and shows you where the case-mix and the money part ways.
Under PDGM, a period with too few visits is not paid a little less, it is repriced entirely to a per-visit rate, and a handful of periods sitting one visit under the threshold is real money that no single claim flags. Period timing, functional-level grouping and OASIS-to-claim consistency each move the case-mix weight, and each is a place a correctly-working billing system will not object because every claim is individually well formed.
Every claim is well formed. The period is where the case-mix and the payment quietly disagree.
Reeve reads the periods against what was paid, finds the LUPA-adjacent periods, the timing and grouping that moved the case-mix, and the OASIS-to-claim gaps that invite review. Neutral, read-only, and nothing with a name ever leaves your building.
Reeve reads your claims, OASIS and payment exports locally in your browser. Identifiers are dropped before any math runs. Read-only, never writes back.
The engine reconstructs each PDGM period, flags LUPA-adjacent periods, timing and grouping that shifted the case-mix, and OASIS-to-claim inconsistencies, then reads them against what the payer actually paid.
Findings are priced off your own paid amounts and verified schedules, and anything the data cannot support is marked rather than guessed.
Home care is the only space Reeve has proven on a real book so far. Home health runs on the same engine, and the PDGM period logic is a design-partner build we would rather do with an agency than in a vacuum.
The engine is the same underneath. What is proven today is one real home-care book, read in full and published with its own corrections at get-reeve.com/proof. Home health runs on that same engine as a design-partner build, and any agency we work with hears that in writing before anything is signed.
See where your PDGM periods and your payments disagree, on your own book. Free, de-identified, yours to keep.
Get a free Margin Review ›