Utah 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. Utah's 365-day timely-filing window is verified in Reeve against a primary source, and it is an absolute outer limit measured from the date of service: past it, a correction may still be accepted but no additional funds are reimbursed, so there is nothing left to recover. Denied-balance findings on a Utah book carry dollars. Reeve has read the Utah Aging Waiver schedule effective January 1, 2026 off the state's published PDF and holds it by code, unit, modifier, and effective date. That is the Aging Waiver, not everything: on a New Choices Waiver or State Plan line, Reeve prices from the rate on your own export or the rate your own remittances actually paid most often rather than assuming the Aging Waiver rate.
Every dollar of Utah Medicaid personal care passes through four states of being, and they do not always agree.
Utah Medicaid requires prior authorization for personal care services reported under T1019, and failure to obtain it results in denial of payment. Reeve reads whatever authorization export you bring and caps recoverable at what was actually authorized. Where there is no authorization, Reeve refuses to quote a dollar it cannot cap.
The aide worked the visit and it landed in the state's EVV system for personal care. The visit becomes an accepted EVV transaction, or it does not, and either way the claim has to line up with it.
A claim went out to Utah Medicaid with a Medicaid ID, date of service, NPI, a HCPCS code, and a unit count. Traditional PCS rides on T1019 per 15 minutes. Units are counted in quarter hours, so small miscounts add up fast.
The claim matched, cleared its other edits, and remitted. Or it hit a mismatch and denied. Denied claims that were already received by the payer still have a resubmission path, but in Utah the 365 days run from the date of service and do not restart: it is an absolute outer limit, not a rolling clock off the last remittance. Past it, a correction may be accepted and still reimburse nothing.
The leaks live in the gaps between those four columns, and Reeve reads across all four rather than trusting any one system's view.
- 01Delivered but never billed
- 02Billed fewer units than the visit shows
- 03Billed at a rate below your own paid modal on the same code
- 04Denied and unbilled since
- 05Aged past the state filing window
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. By the time an annual review names a line that fell past the filing window, the money is gone and the schedule that caused the exposure has kept running. A once-a-year audit is a report on the past. Utah's filing clock does not wait for it.
The EMR is not built to catch it either. Your EMR knows what it billed. The state's EVV system knows what visit was accepted. 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 accepted EVV transaction, 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 Utah: what your EVV records show, what the authorization allowed, what you billed, and what actually paid, read against each other rather than audited for rate.
Plain answers, on the record.
Straight answers on how the Utah 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 Utah?
- 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 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.
- 03What Utah rules is Reeve actually reconciling against?
- Reeve reconciles what your own systems say happened: the authorization, the accepted EVV visit, the claim, the remittance. Utah's 365-day timely-filing window is verified in Reeve against a primary source and is cited on the report, so denied balances still inside it are dollarized. It is an absolute outer limit from the date of service rather than a clock that restarts on the last remittance, so past 365 days a correction may be accepted and reimburse nothing, and Reeve reports those rows as closed rather than recoverable. On rates, Reeve has read the Utah Aging Waiver schedule effective January 1, 2026 off the state's published PDF and holds it by code, unit, modifier, and effective date. It is scoped to that program on purpose: pricing a New Choices Waiver or State Plan line off the Aging Waiver schedule would be an over-quote, so on those lines Reeve prices from your own export's rate or the rate your own remittances actually paid most often, and refuses to quote against any rule it cannot cite.
- 04How does Reeve rank findings against the filing window?
- It ranks findings by days remaining against Utah's 365-day window. Delivered visits closest to the deadline are at the top. Anything past it is marked gone.
- 05Who 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.