Missouri home care margin recovery.
You delivered the visits. In Missouri, effective January 7, 2026 MO HealthNet enforces EVV claim-to-visit matching against the Sandata EAS, and vendors transmit about once a day, so a claim filed ahead of the nightly sync or against an unverified visit denies no visit found. 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.
Every dollar of personal care in Missouri passes through four states of being, and they do not always agree.
The payer approved a number of units. In Missouri that is a MO HealthNet State Plan Personal Care authorization in agency-model Personal Care or Consumer-Directed Services, or an Aged & Disabled Waiver authorization, with an authorized nurse visit priced per visit. The clock and the ceiling both live here.
The attendant worked the visit and it landed in Electronic Visit Verification. Missouri runs an open EVV model, provider-choice, with a state EVV Aggregator Solution hosted by Sandata. The aggregator is aggregator only, it does not originate visits, so every visit has to reconcile in from your EVV vendor and reach verified status.
A claim went out to MO HealthNet with a Medicaid ID, date of service, NPI, a HCPCS code, and a unit count. Personal care rides on T1019 per 15 minutes, and units are counted in quarter hours, so small miscounts add up fast.
The claim matched, cleared its other edits, and remitted. Or it hit no visit found and denied.
The leaks live in the gaps between those four columns, and Missouri has two rules that turn a gap into lost money: as of January 7, 2026 an EVV-required claim denies no visit found if a matching, verified visit is not present in the Sandata EAS at submission, and the 12-month filing clock allows resubmission of denials out to 24 months, after which nothing is paid.
- 01Delivered but never billed
- 02Claim filed ahead of the nightly EAS sync, visit not yet present
- 03Claim filed against a visit that never reached verified status
- 04Billed fewer units than the visit shows
- 05Aged past 12 months on initial, or past 24 months on resubmission
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.
Why an annual audit or the EMR alone misses this.
A once-a-year audit looks back over twelve months. In Missouri the money has a 12-month initial filing clock and a 24-month resubmission ceiling, and the January 7, 2026 EAS matching rule turns timing into denials. By the time an annual review names a no visit found denial, the resubmission window may be closing and the underlying reason lost. A yearly look-back arrives after the filing clock has run out on most of what it finds.
The EMR is not built to catch it either. Your EMR knows what it billed. Your EVV vendor knows what visit fired. The Sandata EAS knows what has actually reconciled and reached verified status. The remittance knows what paid. Those four live in four places, and the mismatch is in the seams between them. A visit that fires cleanly in your vendor system still denies if the claim goes out before the nightly sync lands it in EAS.
The gap only shows when you put the EVV vendor visit, the EAS verified status, the claim submission time, 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 Missouri: what Sandata accepted, what the authorization allowed, what you billed, and what actually paid, read as one row rather than audited for rate.
Plain answers, on the record.
Straight answers on how the Missouri Margin Review works, what it touches, and what it will not claim.
- 01Is Reeve going to tell me a dollar figure for what I can recover in Missouri?
- 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.
- 02Does 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.
- 03What Missouri rule is Reeve actually reconciling against?
- The EVV claim-to-visit matching rule that MO HealthNet enforces as of January 7, 2026. An EVV-required claim denies no visit found unless a matching visit is present in the Sandata EAS and in verified status at submission. Reeve lines up your EVV vendor's visit, the EAS record, the claim, and the remittance and shows you where any of those disagree.
- 04Which Missouri programs and codes does this cover?
- MO HealthNet State Plan Personal Care in agency-model Personal Care and Consumer-Directed Services, and the Aged & Disabled Waiver, with authorized nurse visits priced per visit. Common code is T1019 per 15 minutes.
- 05Our EVV vendor transmits once a day. Does Reeve fix that?
- No, Reeve does not change your vendor cadence. It surfaces every claim that was submitted ahead of the nightly EAS sync so you can hold submission until the visit is verified in EAS, or resubmit inside the 24-month window. The timing trap is the single most avoidable Missouri denial and Reeve makes it visible before the resubmission clock runs out.
- 06How does the 12-month and 24-month rule show up in the review?
- Reeve sorts findings by the operative clock. Initial-filing lines get 12 months. Denials with a resubmission path get 24 months from date of service. Anything past 24 months is marked gone. Delivered visits inside the initial window are at the top; resubmittable denials are ranked by days remaining.
- 07Who 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.
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.
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.
- 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.