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

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 aide 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 South Carolina rules is Reeve actually reconciling against?

Two: the AuthentiCare closed-system requirement, where unresolved exceptions block billing on every visit for that caregiver or client until corrected, and the unit-basis discipline, where state-plan Personal Care is 1-hour and waiver attendant care is 15-minute. Reeve lines up the AuthentiCare record with its exception status, the authorization, the claim, and the remittance and shows you where any of those disagree.

Which South Carolina programs does this cover?

State-plan Personal Care I and II and waiver services under Community Choices, Community Supports, and HASCI, administered by SCDHHS. Reeve refers to the specific personal care codes on your South Carolina fee schedule rather than asserting a single code up front, and it respects the different unit bases per program.

We are required to use AuthentiCare. Does Reeve interfere with that?

No. Reeve reads the export AuthentiCare produces and reconciles it against your claims and remittances. It does not replace AuthentiCare, does not write to it, and does not touch the exception-resolution workflow. It sits above your stack, read-only, and surfaces which caregiver and client profiles are throwing the exceptions that are blocking your billing.

How does the 365-day 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.

South Carolina home care margin recovery.

You delivered the visits. In South Carolina, EVV runs through AuthentiCare as a closed, state-mandated system, an unresolved AuthentiCare exception blocks billing entirely, 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.

Start my free Margin Review

The four numbers

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

Authorized

The payer approved a number of units. In South Carolina that is state-plan Personal Care I or II, or a waiver authorization under Community Choices, Community Supports, or HASCI for attendant care, administered by SCDHHS. State-plan personal care is billed in 1-hour units and waiver attendant care in 15-minute units. The clock, the ceiling, and the unit basis all live here.

Delivered

The aide worked the visit and it landed in Electronic Visit Verification. South Carolina runs a closed, state-mandated EVV system, AuthentiCare. Third-party EVV tools are not accepted. The visit becomes an accepted AuthentiCare transaction, or it hits an exception, and an unresolved exception blocks billing on that visit entirely.

Billed

A claim went out to the correct payer with a Medicaid ID, date of service, NPI, and the personal care code on your South Carolina fee schedule with a unit count that respects the correct unit basis: 1-hour for state-plan personal care, 15-minute for waiver attendant care. Miscounting the unit basis is a quiet source of denials and shortfalls.

Paid

The claim matched, cleared its other edits, and remitted. Or it hit an exception, a unit-basis error, or a filing-clock issue and denied.

The leaks live in the gaps between those four columns, and South Carolina has two rules that turn a gap into lost money: unresolved AuthentiCare exceptions hold billing on every visit for that caregiver or client until corrected, and the unit basis for state-plan personal care is 1-hour while waiver attendant care is 15-minute, so a miscounted line will silently underpay or deny.

01
Delivered but never billed
02
AuthentiCare exception unresolved, visits held
03
State-plan personal care billed in 15-minute units instead of 1-hour
04
Waiver attendant care billed in 1-hour units instead of 15-minute
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

AuthentiCare exception, blocking every visit for the caregiver

3 caregiver profiles this quarter with an unresolved AuthentiCare exception, blocking billing on every visit those caregivers delivered until the profile is corrected. Across the 3 caregivers, 47 visits are currently held, all inside the 365-day filing window and workable today once the underlying exception is resolved. This is the single most avoidable South Carolina shortfall.

Finding B

Unit-basis mismatch, state-plan personal care

9 state-plan Personal Care I or II claim lines billed in 15-minute units where the state-plan basis is 1-hour, so the paid units did not match the delivered hours. Records attached with the visit hours and the correct unit basis, ready to check against your fee schedule and rebill inside the 365-day window.

Finding C

Authorization ceiling versus delivery

3 members where delivered and accepted AuthentiCare units exceed the authorized units on file under state-plan Personal Care or one of the waivers. This is not recoverable, and Reeve will not pretend it is. It surfaces separately as over-delivery, care your aides 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 365-day shelf

16 delivered-and-accepted AuthentiCare visits with no matching claim found in the export, sorted by date of service against the 365-day clock. 11 are still inside the window and billable now. 4 are inside a resubmission window on a prior denial. 3 are gone. The list is ranked by days remaining, so the billable ones are at the top.

Finding E

Client profile exception, waiver attendant care held

2 client profiles with an unresolved AuthentiCare exception on waiver attendant care, holding 18 visits across those clients. 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 South Carolina an unresolved AuthentiCare exception can hold visits every day until it is fixed. By the time an annual review names it, the same exception has been holding new visits for months. A yearly review tells you the size of the leak. It cannot tell you in time to rebill through it.

The EMR is not built to catch it either. Your EMR knows what it billed. AuthentiCare knows what visit was accepted and which caregiver or client profiles are throwing exceptions. The remittance knows what paid or was held. Those three live in three places, and the mismatch is in the seam between them. Unit-basis errors between state-plan personal care and waiver attendant care are exactly the kind of quiet mismatch a clean-looking billing screen hides.

The gap only shows when you put the accepted AuthentiCare transaction with its exception status, the authorization with its unit basis, the claim, 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 South Carolina: what AuthentiCare accepted, what the authorization allowed, what you billed, and what actually paid, lined up rather than audited for rate.

Questions

Plain answers, on the record.

Straight answers on how the South Carolina 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 South Carolina?: 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 aide 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 South Carolina rules is Reeve actually reconciling against?: Two: the AuthentiCare closed-system requirement, where unresolved exceptions block billing on every visit for that caregiver or client until corrected, and the unit-basis discipline, where state-plan Personal Care is 1-hour and waiver attendant care is 15-minute. Reeve lines up the AuthentiCare record with its exception status, the authorization, the claim, and the remittance and shows you where any of those disagree.
04 Which South Carolina programs does this cover?: State-plan Personal Care I and II and waiver services under Community Choices, Community Supports, and HASCI, administered by SCDHHS. Reeve refers to the specific personal care codes on your South Carolina fee schedule rather than asserting a single code up front, and it respects the different unit bases per program.
05 We are required to use AuthentiCare. Does Reeve interfere with that?: No. Reeve reads the export AuthentiCare produces and reconciles it against your claims and remittances. It does not replace AuthentiCare, does not write to it, and does not touch the exception-resolution workflow. It sits above your stack, read-only, and surfaces which caregiver and client profiles are throwing the exceptions that are blocking your billing.
06 How does the 365-day 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.