Is Reeve going to tell me a dollar figure for what I can recover in Louisiana?

No made up numbers. Reeve prices findings off the rate on your own export or the rate your own remittances actually paid most often, and where it cannot find a rate in your data it gives you the hours, the units, and the exact records instead of a dollar figure. A rate Reeve has not verified is a rate Reeve will not quote.

Does my data leave my building?

No. The Margin Review runs in your own browser on an export you provide. Client names, Medicaid IDs, and attendant names are replaced with a coded reference locally before any math runs. Nothing with a name on it is uploaded or sent anywhere. Reeve reads. It does not write to your EMR, does not file a claim, and does not move money.

What Louisiana rule is Reeve actually reconciling against?

Two: the LaSRS EVV requirement that gates the prior authorization release under LT-PCS, and the weekly authorized ceiling that cannot be banked, borrowed, or saved across weeks. A claim without an accepted LaSRS visit and a released PA does not pay, and hours above the weekly amount are non-reimbursable. Reeve lines up the LaSRS record, the PA, the claim, and the remittance and shows you where any of those disagree.

Which Louisiana programs and codes does this cover?

Long Term-Personal Care Services for adults 21 and over administered by LDH OAAS, EPSDT-PCS for members under 21, and attendant hours under the Community Choices Waiver and the New Opportunities Waiver. LT-PCS rides on T1019 per 15 minutes with staffing-ratio modifiers UB for one-on-one, UN for two shared attendants, and UP for three.

We already report through LaSRS. Do we need to change anything?

No. Reeve reads the export LaSRS produces and reconciles it against your claims and remittances. It does not replace LaSRS, does not write to it, and does not change how you report visits. It sits above your stack, read-only.

How does the no-banking-hours rule show up in the review?

As exposure, not recoverable. Reeve totals delivered and accepted LaSRS hours per client per week and flags every week that exceeds the authorized weekly LT-PCS amount, even when the prior weeks were below the ceiling. Louisiana does not allow banking or borrowing, so those over-week hours are surfaced as exposure and separated from recoverable findings.

Who runs the review, and is there a catch?

You do, yourself, for free. There is no sales call required to try it, no automated nightly scanning of your systems, and no team quietly holding your data. You provide an export, the review runs locally, and you keep the findings whether or not we ever work together.

Louisiana home care margin recovery.

You delivered the visits. In Louisiana, LT-PCS hours cannot be banked across weeks, prior authorization release is contingent on the LaSRS EVV record, and the filing clock is 365 days. Reeve reads your own billing export, right in your browser, and shows you the authorized, delivered, billed, and paid columns side by side, so the gaps have a record attached.

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The four numbers

Every dollar of personal care in Louisiana passes through four states of being, and they do not always agree.

Authorized

The payer approved a number of units. In Louisiana that is a Long Term-Personal Care Services authorization for adults 21 and over, administered by LDH OAAS, an EPSDT-PCS authorization for members under 21, or attendant hours under the Community Choices Waiver or New Opportunities Waiver. LT-PCS is an authorized weekly amount and it does not roll forward. The clock and the ceiling both live here.

Delivered

The attendant worked the visit and it landed in Electronic Visit Verification through the state-designated aggregator LaSRS, the Louisiana Services Reporting System. Louisiana does not run through Sandata or HHAeXchange for LT-PCS. The visit becomes an accepted LaSRS transaction, or it does not, and the prior authorization release is tied to that record.

Billed

A claim went out to Louisiana Medicaid with a Medicaid ID, date of service, NPI, a HCPCS code, its staffing-ratio modifier, and a unit count. LT-PCS rides on T1019 per 15 minutes under a prospective payment methodology, with UB for one-on-one, UN for two shared attendants, and UP for three. Units are counted in quarter hours and the staffing modifier changes the rate.

Paid

The claim matched, cleared its other edits, and remitted. Or it hit a mismatch and denied.

The leaks live in the gaps between those four columns, and Louisiana has two rules that turn a gap into lost money: prior authorization release depends on the LaSRS record and no PA means no payment with no exceptions, and hours delivered beyond the authorized weekly amount cannot be banked, borrowed, or saved, they are non-reimbursable exposure.

01
Delivered but never billed
02
LaSRS visit missing or not accepted, PA never released
03
Staffing modifier mismatch between visit and claim
04
Billed fewer units than the visit shows inside the weekly authorization
05
Aged past the 365-day filing window

Illustrative findings

Every number is illustrative and synthetic. Because your own export may not carry a rate for every code, findings on this page are expressed in hours, units, and records to check against your own rate sheet, never in dollars Reeve made up.

Finding A

T1019 unit mismatch, silent shortfall

8 LT-PCS claims paid clean this quarter where the accepted LaSRS visit shows more delivered quarter-hour units than the claim billed. Example: a visit accepted for 12 units of T1019 UB, claim billed 8. The claim matched and paid, so nothing flagged, but 4 units per visit across 8 visits is 32 units of delivered care that never turned into a claim line. Records attached, ready to check against your contracted rate.

Finding B

Staffing-ratio modifier mismatch, denied and not reworked

11 denied claim lines where the staffing-ratio modifier on the claim does not match the accepted LaSRS visit. Example: the visit accepted as UN for two shared attendants, the claim submitted as UB for one-on-one, which changes the rate. Nine of the eleven are still inside the appeal window and reworkable today. The other two are past the clock.

Finding C

Weekly LT-PCS ceiling versus delivery

3 clients where delivered and accepted LaSRS hours exceed the authorized weekly LT-PCS amount, with prior weeks below the ceiling. Louisiana does not allow banking or borrowing across weeks, so the over-week hours are not recoverable, and Reeve will not pretend they are. It surfaces separately as over-delivery, care your attendants gave that was never authorized this week, so you can see the exposure and fix the schedule going forward rather than quote it as money owed.

Finding D

Timely-filing risk, the 365-day shelf

16 delivered-and-accepted LaSRS visits with no matching claim found in the export, sorted by date of service against the 365-day clock. 7 are still inside the window and billable now. 4 are between 365 days and any resubmission window with a prior denial to rework. 3 are past 365 and gone. The list is ranked by days remaining, so the billable ones are at the top.

Finding E

PA release blocked by missing LaSRS visit

6 visits where the LaSRS record is missing, incomplete, or not accepted, blocking the prior authorization release for the billing period. Each one is a denial waiting to happen or one that already did, with the specific visit and claim record paired so your biller can see exactly which field to correct.

The blind spot

Why an annual audit or the EMR alone misses this.

A once-a-year audit looks back over twelve months. In Louisiana the money has a 365-day clock and weekly ceilings that do not roll forward. By the time an annual review names an over-week or a PA-blocked denial, the week is long past and the schedule that caused the exposure is set in stone. An annual look-back names the loss. It names it after the window has already closed on it.

The EMR is not built to catch it either. Your EMR knows what it billed. LaSRS knows what visit was accepted and whether the PA released. The remittance knows what paid. Those three live in three places, and the mismatch is in the seam between them. A clean match shows green in your billing screen even when the visit carried more units than the claim, or when the staffing modifier disagreed with the accepted visit.

The gap only shows when you put the accepted LaSRS transaction, the PA release, the claim with its staffing modifier, and the remittance in the same view and read them together, week by week against the authorized weekly ceiling. That is the one thing Reeve does. It reads across the seam.

That is what Reeve reads for in Louisiana: what LaSRS accepted, what the authorization allowed, what you billed, and what actually paid, read against each other rather than audited for rate.

Questions

Plain answers, on the record.

Straight answers on how the Louisiana Margin Review works, what it touches, and what it will not claim.

01 Is Reeve going to tell me a dollar figure for what I can recover in Louisiana?: No made up numbers. Reeve prices findings off the rate on your own export or the rate your own remittances actually paid most often, and where it cannot find a rate in your data it gives you the hours, the units, and the exact records instead of a dollar figure. A rate Reeve has not verified is a rate Reeve will not quote.
02 Does my data leave my building?: No. The Margin Review runs in your own browser on an export you provide. Client names, Medicaid IDs, and attendant names are replaced with a coded reference locally before any math runs. Nothing with a name on it is uploaded or sent anywhere. Reeve reads. It does not write to your EMR, does not file a claim, and does not move money.
03 What Louisiana rule is Reeve actually reconciling against?: Two: the LaSRS EVV requirement that gates the prior authorization release under LT-PCS, and the weekly authorized ceiling that cannot be banked, borrowed, or saved across weeks. A claim without an accepted LaSRS visit and a released PA does not pay, and hours above the weekly amount are non-reimbursable. Reeve lines up the LaSRS record, the PA, the claim, and the remittance and shows you where any of those disagree.
04 Which Louisiana programs and codes does this cover?: Long Term-Personal Care Services for adults 21 and over administered by LDH OAAS, EPSDT-PCS for members under 21, and attendant hours under the Community Choices Waiver and the New Opportunities Waiver. LT-PCS rides on T1019 per 15 minutes with staffing-ratio modifiers UB for one-on-one, UN for two shared attendants, and UP for three.
05 We already report through LaSRS. Do we need to change anything?: No. Reeve reads the export LaSRS produces and reconciles it against your claims and remittances. It does not replace LaSRS, does not write to it, and does not change how you report visits. It sits above your stack, read-only.
06 How does the no-banking-hours rule show up in the review?: As exposure, not recoverable. Reeve totals delivered and accepted LaSRS hours per client per week and flags every week that exceeds the authorized weekly LT-PCS amount, even when the prior weeks were below the ceiling. Louisiana does not allow banking or borrowing, so those over-week hours are surfaced as exposure and separated from recoverable findings.
07 Who runs the review, and is there a catch?: You do, yourself, for free. There is no sales call required to try it, no automated nightly scanning of your systems, and no team quietly holding your data. You provide an export, the review runs locally, and you keep the findings whether or not we ever work together.

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.

No sales call. No account to create. Export your data, open the review in your browser, and see your authorized, delivered, billed, and paid columns lined up in about the time it takes to read this page.

Start my free Margin Review

01
Read-only. Reeve reads your export and does not write to your EMR, does not file a claim, does not move money.
02
Names coded locally. Names and Medicaid IDs are replaced with a coded reference in your browser before any analysis runs.
03
Your file is processed in your browser, and no name is written into any output. No upload of identified data, no server holding your client list.
04
Yours to keep. The findings are yours whether or not we ever work together.

Reeve reads your billing read-only and replaces its names with coded references before any math runs. Every example figure is illustrative and synthetic, method rather than results, and Reeve makes no guarantee of recovery.