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

Only where it can stand behind it. South Dakota pays the lesser of your usual and customary charge or the published maximum, so Reeve prices at the lesser of the rate in your own data and the published fee it holds, and it says so on the finding. Where your export carries no charge, Reeve discloses that the lesser-of rule could not be applied and gives you the hours, the units, and the exact records instead of a dollar figure.

Does my data leave my building?

No. The Margin Review runs in your own browser on an export you provide. Client names, member identifiers, and the names of the people who deliver the care 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 is the South Dakota filing window, exactly?

South Dakota Medicaid must receive a completed claim within 6 months following the month the services were provided. It is month anchored, not day anchored, so the clock runs from the end of the month of service rather than from the date of the visit. Correction of a denied claim runs 3 months from the denial notice, and adjust or void of a paid claim runs 3 months. Third party and Medicare coordination runs 6 months from the payment or denial notice, and retroactive eligibility runs 6 months. That is verified in Reeve against ARSD 67:16:35:04 and the South Dakota Medicaid General Claim Guidance, and the citation is printed on the report.

Which South Dakota rates does Reeve hold?

The personal care agency, ADLS Waiver, HOPE Waiver, and home health schedules effective July 1 2026, held by code, unit, modifier, and effective date, along with the state's authorized modifier table with its own separate effective date. South Dakota publishes by state fiscal year, so Reeve tracks the July 1 boundary and will tell you when the schedule it holds may have been superseded rather than quietly pricing off a stale document. Where the state prints two different dollars under the same key, such as the residential per diems that differ by program, Reeve refuses to pick one and says the key is incomplete.

How does the 8-minute increment floor show up?

South Dakota bills in 15-minute increments. A visit under 8 minutes is not underbilled, it is unbillable, so Reeve returns zero units on it rather than calling it a shortfall. Above the floor, Reeve rounds to the nearest quarter hour and discloses that the rounding happened when your export carries hours rather than minutes.

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 Dakota home care margin recovery.

You delivered the visits.

Reeve reads your own billing export, right in your browser, and lines up authorized, delivered, billed, and paid side by side so the gaps between them have a record attached. South Dakota's filing window is verified in Reeve against a primary source and it is month anchored rather than day anchored: South Dakota Medicaid must receive a completed claim within 6 months following the month the services were provided. Reeve has read the South Dakota personal care, ADLS Waiver, HOPE Waiver, and home health schedules effective July 1 2026 and holds them by code, unit, modifier, and effective date. South Dakota pays the lesser of your usual and customary charge or the published maximum, so Reeve prices at the lesser of the two rather than treating the published number as what you were owed.

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The four numbers

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

Authorized

The payer approved a number of units. Reeve reads whatever authorization export you bring and caps recoverable at what was actually authorized. Where there is no authorization in the file, Reeve refuses to quote a dollar it cannot cap.

Delivered

The aide worked the visit and it landed in your visit record. South Dakota bills personal care in quarter hours, and a visit shorter than 8 minutes is not underbilled, it is unbillable, so Reeve holds an 8-minute increment floor and rounds to the nearest 15 minutes above it rather than inventing a partial unit.

Billed

A claim went out to South Dakota Medicaid with a Medicaid ID, date of service, NPI, a HCPCS code, and a unit count. Personal care rides on T1019 per 15 minutes, homemaker on S5130, attendant care on S5125, respite on T1005. Units are counted in quarter hours, so small miscounts add up fast.

Paid

The claim matched, cleared its other edits, and remitted. Or it hit a mismatch and denied. South Dakota gives 3 months to correct a denied claim, measured from the denial notice, and 3 months to adjust or void a paid claim. Those are separate clocks from the 6-month initial window and they do not extend it.

The leaks live in the gaps between those four columns, and Reeve reads across all four rather than trusting any one system's view.

01
Delivered but never billed
02
Billed fewer units than the visit shows
03
Billed at a rate below your own paid modal on the same code
04
Denied and unbilled since, with the 3-month correction clock running
05
Aged past the 6-month window that closes at the end of the month of service

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

9 personal care claims paid clean this quarter where the visit record shows more delivered quarter-hour units than the claim billed. Example: a visit that supports 12 units of T1019, claim billed 10. The claim matched and paid, so nothing flagged, but 3 units per visit across 9 visits is 27 units of delivered care that never turned into a claim line. Records attached, ready to check against your own charge and the published maximum.

Finding B

Delivered visits with no matching claim

9 accepted visits for T1019 with no corresponding line in the billing export. The care was given and the visit is on the record; the claim never went out.

Finding C

Authorization ceiling versus delivery

3 members where delivered units exceed the authorized units on file. This is not recoverable, and Reeve will not pretend it is. It surfaces separately as over-authorized delivery, care the people who deliver it 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

Paid below your own modal rate on the same code

14 paid T1019 lines where the per-unit rate came in below the modal rate your own remittances paid on that code this period. Sourced from your own data, not from a published maximum Reeve would have to assume you charged.

Finding E

Timely-filing risk, sorted against the month-end anchor

15 delivered visits with no matching claim found in the export, ranked against the 6-month window that runs from the end of the month the service was provided. The lines closest to the window are at the top; anything past it is marked gone rather than quoted.

The blind spot

Why an annual audit or the EMR alone misses this.

A once-a-year audit looks back over twelve months, and South Dakota's initial window is 6 months following the month of service. By the time an annual review names a line that fell past the window, the money is gone and the schedule that caused the exposure has kept running. A once-a-year review is a post-mortem. The month-anchored windows in South Dakota close long before it runs.

The EMR is not built to catch it either. Your EMR knows what it billed. The visit record knows what was delivered. The remittance knows what paid. Those three live in three places, and the mismatch is in the seam between them.

The gap only shows when you put the visit, the member's authorization, the claim with its code, 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 Dakota: what your EVV aggregator accepted, what the authorization allowed, what you billed, and what actually paid, lined up in one view rather than audited for rate.

Questions

Plain answers, on the record.

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

: Only where it can stand behind it. South Dakota pays the lesser of your usual and customary charge or the published maximum, so Reeve prices at the lesser of the rate in your own data and the published fee it holds, and it says so on the finding. Where your export carries no charge, Reeve discloses that the lesser-of rule could not be applied and gives you the hours, the units, and the exact records instead of a dollar figure.
: No. The Margin Review runs in your own browser on an export you provide. Client names, member identifiers, and the names of the people who deliver the care 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.
: South Dakota Medicaid must receive a completed claim within 6 months following the month the services were provided. It is month anchored, not day anchored, so the clock runs from the end of the month of service rather than from the date of the visit. Correction of a denied claim runs 3 months from the denial notice, and adjust or void of a paid claim runs 3 months. Third party and Medicare coordination runs 6 months from the payment or denial notice, and retroactive eligibility runs 6 months. That is verified in Reeve against ARSD 67:16:35:04 and the South Dakota Medicaid General Claim Guidance, and the citation is printed on the report.
: The personal care agency, ADLS Waiver, HOPE Waiver, and home health schedules effective July 1 2026, held by code, unit, modifier, and effective date, along with the state's authorized modifier table with its own separate effective date. South Dakota publishes by state fiscal year, so Reeve tracks the July 1 boundary and will tell you when the schedule it holds may have been superseded rather than quietly pricing off a stale document. Where the state prints two different dollars under the same key, such as the residential per diems that differ by program, Reeve refuses to pick one and says the key is incomplete.
: South Dakota bills in 15-minute increments. A visit under 8 minutes is not underbilled, it is unbillable, so Reeve returns zero units on it rather than calling it a shortfall. Above the floor, Reeve rounds to the nearest quarter hour and discloses that the rounding happened when your export carries hours rather than minutes.
: 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.

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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 member identifiers 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.