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

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 support worker 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 Minnesota rule is Reeve actually reconciling against?

The Optum pre-payment review rule that billed hours have to match the HHAeXchange clock-in and clock-out exactly on member, date, and hours. A claim billed for more or fewer hours than the EVV clock supports is held, denied, or silently overpaid. Reeve lines up the HHAeXchange clock, the claim's billed hours, and the remittance and shows you where any of those disagree.

We already report through HHAeXchange. Does Reeve replace it?

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

How does the 12-month filing window show up in the review?

Reeve sorts findings by the 365-day clock. Delivered visits inside the window are billable now and go to the top. Lines inside a resubmission window on a prior denial are ranked next. Anything past the operative window is marked gone rather than dressed up.

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.

Minnesota CFSS home care margin recovery.

You delivered the visits. In Minnesota, effective October 1, 2024 Community First Services and Supports replaced PCA and folded in CSG, HHAeXchange is the statewide EVV aggregator, and under Optum pre-payment review a claim's hours have to match the EVV clock-in and clock-out exactly, or the line is held. 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 Minnesota passes through four states of being, and they do not always agree.

Authorized

The payer approved a number of units. In Minnesota that is a Community First Services and Supports authorization, the program that as of October 1, 2024 replaced Personal Care Assistance and folded in the Consumer Support Grant. The clock and the ceiling both live here.

Delivered

The support worker delivered the service and it landed in Electronic Visit Verification. Minnesota runs an open EVV model with HHAeXchange as the statewide aggregator. The visit becomes an accepted HHAeXchange transaction, or it does not, and the clock-in and clock-out on that record are what pre-payment review will compare against.

Billed

A claim went out to the payer with a Medicaid ID, date of service, NPI, T1019 per 15 minutes, and a unit count that translates back to a start time, an end time, and total hours. Units are counted in quarter hours, so small miscounts add up fast.

Paid

The claim matched, cleared pre-payment review, and remitted. Or the billed hours did not agree with the EVV clock-in and clock-out and the line was held or denied.

The leaks live in the gaps between those four columns, and Minnesota has one particular rule that turns a gap into lost money: under Optum pre-payment review, billed hours have to match the EVV clock-in and clock-out exactly on member, date, and hours, with effectively no variance tolerance. A claim billed for 4 hours against a 3.5-hour EVV record is held or denied, no matter that the visit really happened.

01
Delivered but never billed
02
Billed hours do not match the HHAeXchange clock-in and clock-out
03
Rounded-up hours held or denied under pre-payment review
04
HHAeXchange visit missing or unreconciled at claim time
05
Aged past the 12-month 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

Billed hours over EVV clock, held under pre-payment review

14 CFSS claim lines this quarter where the billed hours exceed the HHAeXchange clock-in-to-clock-out span, most often because the biller rounded up. Example: a visit clocked at 3 hours 30 minutes, claim billed as 4 hours. Under Optum pre-payment review these lines are held or denied. All 14 are workable today by rebilling to the exact EVV span, inside the 12-month window.

Finding B

Billed hours under EVV clock, silent shortfall

10 CFSS claim lines paid clean this quarter where the HHAeXchange clock-in-to-clock-out span shows more hours than the claim billed. Example: a visit clocked at 4 hours 15 minutes, claim billed as 4 hours. The claim matched and paid, so nothing flagged, but that quarter-hour per visit across 10 visits is delivered care that never turned into a claim line. Records attached, ready to check against your contracted rate.

Finding C

Authorization ceiling versus delivery

3 members where delivered and accepted HHAeXchange hours exceed the authorized CFSS units on file. This is not recoverable, and Reeve will not pretend it is. It surfaces separately as over-delivery, care your support workers gave that was never authorized, so you can see the exposure and fix the auth going forward rather than quote it as money owed.

Finding D

Timely-filing risk, the 12-month shelf

17 delivered-and-accepted HHAeXchange visits with no matching claim found in the export, sorted by date of service against the 365-day clock. 12 are still inside the window and billable now. 4 are inside a resubmission window on a prior denial, workable if reworked promptly. 3 are gone. The list is ranked by days remaining, so the billable ones are at the top.

Finding E

HHAeXchange visit missing at claim time

5 visits where the support worker delivered the service in your vendor system but the HHAeXchange record is missing, incomplete, or not accepted at the time the claim was submitted. 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 Minnesota, Optum pre-payment review is checking billed hours against the EVV clock every day. By the time an annual review names a rounded-up line, the same rounding has been repeating for months and the recoverable resubmissions are already old. The annual audit measures the loss. Measuring is not recovering, and by then it is only measuring.

The EMR is not built to catch it either. Your EMR knows what it billed. HHAeXchange knows the exact clock-in and clock-out. The remittance knows what paid or held. Those three live in three places, and the mismatch is in the seam between them. A clean-looking billing screen does not tell you that a 3.5-hour EVV span was billed as 4 hours until Optum holds it.

The gap only shows when you put the HHAeXchange clock, the CFSS authorization, the claim with its billed hours, and the remittance in the same view and read them together. That is the one thing Reeve does. It reads across the seam.

That is what Reeve reads for in Minnesota: what HHAeXchange accepted, what the authorization allowed, what you billed, and what actually paid, read side by side rather than audited for rate.

Questions

Plain answers, on the record.

Straight answers on how the Minnesota 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 Minnesota?: 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 support worker 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 Minnesota rule is Reeve actually reconciling against?: The Optum pre-payment review rule that billed hours have to match the HHAeXchange clock-in and clock-out exactly on member, date, and hours. A claim billed for more or fewer hours than the EVV clock supports is held, denied, or silently overpaid. Reeve lines up the HHAeXchange clock, the claim's billed hours, and the remittance and shows you where any of those disagree.
04 Which Minnesota program does this cover?: Community First Services and Supports, the program that as of October 1, 2024 replaced Personal Care Assistance and folded in the Consumer Support Grant. Common code is T1019 per 15 minutes.
05 We already report through HHAeXchange. Does Reeve replace it?: No. Reeve reads the export HHAeXchange produces and reconciles it against your claims and remittances. It does not replace HHAeXchange, does not write to it, and does not change how you capture visits. It sits above your stack, read-only.
06 How does the 12-month filing window show up in the review?: Reeve sorts findings by the 365-day clock. Delivered visits inside the window are billable now and go to the top. Lines inside a resubmission window on a prior denial are ranked next. Anything past the operative window is marked gone rather than dressed up.
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.