What a Home-Care Margin Review actually finds.
A Margin Review is not a sales demo and it is not a promise. It is a read-only pass over an agency's own authorizations, EVV visits, claims, and remittances for one closed period. It compares what was authorized, delivered, billed, and paid, then reports the revenue that fell through the cracks.
Why it leads with proof
Home-care software is sold on promises. A Margin Review is the opposite posture. Before any conversation about tools or workflow, the review reads the agency's own data and reports what it found. Nothing is generalized from anyone else's book. Every finding points back at a specific record in your own export.
The output is a line-by-line ranking of leaks, each with the reason attached, so the owner can decide what is worth reworking and what is worth fixing upstream.
The six categories it surfaces
- ›Unbilled authorized hours. Care that was delivered inside the authorization and never turned into a claim.
- ›Unit and code mismatches. Claims that deny because a field, units, service code, modifier, date, does not match the EVV record.
- ›Silent underpayments. Claims paid at a rate below the contracted rate for the code. No denial fires; the AR looks normal.
- ›Denied and never-reworked claims. Denials still inside the appeal window that no one has touched.
- ›Authorization drift and lapses. Visits that continued past an auth end date, or against a stale service code the payer no longer accepts.
- ›Overtime and scheduling leakage. Patterns where a single caregiver, shift, or branch consistently pushes hours into unfavorable pay or coverage rules.
What the read actually is
Read only. Reeve does not write back to the EMR, does not submit or correct a claim, and does not move money. Every action stays with the agency.
Names coded locally. Client names and Medicaid IDs are replaced with a coded reference unique to your agency in the browser before any analysis runs. Your file is processed in your browser, and no name is written into any output.
EMR-neutral. The same review runs against exports from WellSky, AxisCare, HHAeXchange, and AlayaCare, because it works from the reconciled data, not the vendor screen.
What you do with the findings
Work the time-sensitive dollars first. Rework recoverable denials and file the unbilled hours that are still inside the filing window. Recovery windows close, so priority is set by deadline, not by size.
Then fix the process leaks that produced them. Authorization drift, EVV mismatches, and rate mismatches are structural. Ranked in one list, they tell you which process to fix first.
Plain answers, on the record.
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.
Run the review on your own numbers.
Export a closed billing month, open the review, and see the six categories filled in with your own lines. Free, in your browser, read only.