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Washington home care agencies: find the care you delivered but never got paid for.

You earned this margin. Let's make sure Apple Health actually paid you for it. Reeve is a free, read-only Margin Review that reconciles what a payer authorized, what your caregivers delivered, what you billed, and what ProviderOne actually paid, then shows you every place those four numbers disagree, with the record attached.

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The four numbers

Every dollar of personal care margin in Washington passes through four columns that are supposed to agree and often do not.

Authorized

Washington Apple Health is run by the Health Care Authority, and in-home personal care is authorized through ALTSA and DDA. Your client's assessment sets an authorized number of units, usually T1019 in 15-minute increments, with a start date, an end date, and a ceiling.

Delivered

Your caregivers deliver the care and the visit is captured through EVV. Washington runs an open, provider-choice model: each agency picks its own EVV vendor, and all visit data has to flow into ProviderOne. There is no single national aggregator reconciling the match for you.

Billed

Your biller or EMR submits the claim to ProviderOne, where the visit data and the claim have to line up. If the EVV record and the claim do not match, ProviderOne holds an exception and blocks payment on the affected visit. That is Washington's version of no-match, no-pay.

Paid

The remittance comes back. Some lines pay, some deny, some pay short, and some visits never made it onto a claim at all. Washington gives you a hard clock: 12 months from the date of service. Once that window closes, the margin is gone for good.

The money does not leak in any one column. It leaks in the gaps between them.

  • 01
    Delivered but never billed: a visit happened, EVV captured it, but no claim line ever went out.
  • 02
    Delivered above the authorization: caregivers delivered more units than ALTSA or DDA authorized.
  • 03
    EVV-to-claim mismatch held at ProviderOne: the line silently fails to pay.
  • 04
    Authorization lapse: care delivered after an end date or before a renewal posted.
  • 05
    Timely-filing risk: delivered, clean, and simply aging toward the 12-month wall.
Illustrative findings

Every number is illustrative and synthetic. For Washington, findings are expressed in hours, units, and records to check against your own rate sheet, not in dollars.

Finding A
Delivered but never billed
Reconciling a quarter of EVV visit records against submitted claim lines surfaces 214 T1019 visits, roughly 1,300 fifteen-minute units, captured in EVV but never appearing on any claim to ProviderOne. Output: the 214 records, dates, and unit counts, ready to file before the 12-month window closes.
Finding B
EVV exception holding payment
68 visits where the claim line and the EVV record do not reconcile and payment appears held at ProviderOne. Output: the 68 records with the point of disagreement flagged, whether time, unit count, or client match, so your team can resolve the exception rather than write the visit off.
Finding C
Delivered past the authorization end date
9 clients where delivered units continue past the ALTSA or DDA authorization end date, about 340 units of care sitting outside a live authorization. Output: the client-level records so you can confirm whether a renewal was late-posted or the care was genuinely unauthorized.
Finding D
Over-delivery, flagged, not counted
5 clients where delivered units exceed the authorized ceiling by a combined 180 units. Output: these are shown as over-delivered units and explicitly excluded from anything recoverable, because Medicaid will not pay above the authorization. This is an operations flag, not a recovery claim.
Finding E
Timely-filing cliff
Sorting unbilled delivered visits by date of service surfaces 47 visits now inside 60 days of the 12-month filing deadline. Output: a dated worklist so the oldest, most at-risk care gets filed first.
The blind spot

Why an annual audit or the EMR alone misses this in Washington.

01

Your EMR only knows what you put in it: the claims you submitted and the remits that came back. Nothing in it asks which delivered, EVV-captured visits never became a claim line at all. A visit that was never billed does not show up as a denial, because there is nothing to deny. It shows up as nothing, and nothing is exactly what a denial report cannot see.

02

Nothing in Washington reconciles your EVV records to your claims for you. Because Washington uses an open provider-choice model rather than a single state aggregator that reconciles visits to claims for you, the match happens across a handoff. Seams are where records fall through. A held ProviderOne exception that never gets worked looks, from inside the EMR, like a line that simply is not paying yet.

03

An annual audit is a snapshot against a clock that never stops. Washington's 12-month timely-filing window runs per date of service, every day. By the time a yearly review runs, the oldest unbilled care may already be past filing, which turns a finding into a eulogy. Reconciliation has to run against closed periods, often, while there is still time to file.

Reeve is that line-up. Read-only, on an export you already have, run as often as you want instead of once a year.

Questions

Plain answers, on the record.

The honest version of what Reeve does, what it does not do, and where Washington's rules bite.

01
What does the Reeve Margin Review actually do for a Washington home care agency?
It reconciles four things that are supposed to agree: what Apple Health authorized through ALTSA or DDA, what your caregivers delivered and captured in EVV, what you billed to ProviderOne, and what actually paid. Where those disagree, Reeve shows you the specific records: visits delivered but never billed, EVV-to-claim mismatches held at ProviderOne, care delivered past an authorization, and visits aging toward the timely-filing deadline.
02
Does Reeve tell me my recovery in dollars for Washington?
No, and that is on purpose. Reeve never invents a rate. Dollars come from the rate on your own export or the rate your own remittances actually paid most often. Where Reeve cannot find a rate in your data, the finding comes to you in hours, units, and the exact records. A rate Reeve has not verified is a rate Reeve will not quote. For Washington, Reeve reports the hours, units, and records where your four columns disagree, and you apply your own contracted rate sheet.
03
Is my client data safe? Does anything with a name on it leave my building?
Your file is processed in your browser, and no name is written into any output. The Margin Review runs read-only, in your own browser, on an export you provide, and it replaces names with a coded reference locally before any analysis. Reeve reads. It does not write back to your EMR, does not file a claim, and does not move money.
04
Which EVV system does this work with in Washington?
Washington uses an open, provider-choice EVV model, so agencies pick their own EVV vendor and the data flows into ProviderOne. Reeve does not need to plug into your EVV vendor. It works from an export of your visit and billing data, so the specific vendor you use does not gate the review.
05
What is the ProviderOne exception that blocks my payment?
When a claim line and its EVV record do not reconcile, ProviderOne holds an exception on that visit, and an unresolved exception blocks payment on the affected care. It is Washington's no-match, no-pay mechanism. Because these can sit unworked, they often look like lines that simply have not paid yet. Reeve surfaces the specific records so your team can resolve them.
06
How long do I have to bill delivered care in Washington?
The initial claim timely-filing window for Apple Health is 12 months from the date of service, with a longer window up to 24 months only in retroactive-eligibility situations. Delivered care that stays unbilled past that window is not recoverable. Reeve sorts unbilled visits by date so the most at-risk care surfaces first.
07
How does Reeve report findings for Washington?
Every number on this page is labeled illustrative and synthetic. What Reeve offers today is a free, honest, read-only look at your own data, run by operators, not a pitch built on other people's logos. Reeve never invents a rate; dollars come from the rate on your own export or the rate your own remittances actually paid most often.
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.

Run the Margin Review on your own Washington export, in your own browser. If it finds delivered care that never turned into a clean claim, that is yours to go collect, whether or not we ever work together. If it finds nothing, you have lost an hour and confirmed your billing is tight. Either answer is worth having.

Start my free Margin Review
  • 01

    Read-only. Reeve looks. It does not write to your EMR, does not file a claim, does not move a dollar.

  • 02

    Names coded locally. Client names, staff names, and identifiers are replaced with a coded reference unique to your agency in your own browser before any analysis runs. No name touches the math.

  • 03

    The review runs on an export you control. No client-named record is uploaded anywhere.

  • 04

    Honest by default. For Washington, findings come back as hours, units, and records to price against your own rate sheet.

Any dollar figures in examples are illustrative and synthetic, method rather than results.