As the year comes to a close, healthcare organizations feel the same pressure they always do: closing out accounts, speeding up collections, settling outstanding claims, and getting rid of operational bottlenecks before January 1st. The last three months of the year are often the most important for a company’s financial health. What happens now will determine whether companies start the New Year strong or with a lot of unfinished business.
For many practices, the problems stay the same: a lot of claims, slow responses from payers, coding mistakes, delays in getting prior authorization, confusion about who is responsible for what, and limited resources that get even tighter during the holidays. But this year brings more scrutiny from payers and economic stress, so it’s even more important to improve Revenue Cycle Management (RCM) performance before the end of the year.
The good news is? Year-end problems also bring year-end chances, like the chance to collect money that might otherwise be written off, make workflows more efficient, lower old accounts receivable, and get teams ready for a more productive year ahead.
This newsletter goes into great detail about the best Year-End RCM strategies that your business should focus on right now to get ready for 2026 by improving collections, lowering backlogs, and making sure your finances are in order.
Why Year-End RCM Efforts Matter More Than Ever
Revenue cycle bottlenecks grow exponentially if not addressed proactively. Unresolved claims or unbilled visits today lead to:
-
- Aging AR balances that are increasingly harder to recover
- More claims beyond timely filing limits
- Increased denials due to outdated benefits or coverage lapses
- Declining year-over-year revenue performance
- Operational overload in Q1
The final quarter should not be a scramble—it should be a strategically driven clean-up phase to convert pending revenue into real cash flow.
Focusing now on high-impact RCM improvements means:
-
- Boosting cash collections before fiscal close
- Reducing bad debt and avoidable write-offs
- Improving payer compliance and audit readiness
- Enhancing staff efficiency and morale
- Setting a strong performance baseline for next year
Financial health is not determined only by how much revenue is generated—but by how much is successfully collected. Year-end is the time to protect what you’ve already earned.
Top Year-End Strategies for Improving Collections and Eliminating Backlogs
Below is a step-by-step plan leading practices are using this season to close revenue gaps and operational inefficiencies.
Conduct Aged AR Deep Dive & Prioritize High-Risk Claims
Aged AR is normally the largest source of unrealized cash. At year-end, prioritizing these accounts is non-negotiable.
Focus should be on:
-
- 30–60 days: Resolve before they slip into denials or rejections
- 90+ days: Highest risk of write-off — escalate aggressively
- Payer-specific delays: Identify trends and fast-track corrections
Segment AR for immediate action:
| Category | Strategy |
| High-value claims | Escalate and follow up daily |
| Claims near timely filing | Correct and submit ASAP |
| Patient AR | Initiate final notices, payment plans, digital reminders |
| Pending clinical documentation | Get rapid provider turnaround |
Even a 5–10% improvement in aged AR recovery can have a massive year-end impact.
Accelerate AR Touch Rates with a Clear Follow-Up Protocol
Many claims remain unpaid simply because they were never followed up on at the right interval. Payers exploit delays—your team must close the communication gaps.
Implement:
-
- Daily follow-up for high-dollar accounts
- 48–72 hour follow-up after each payer interaction
- Automated reminders and priority worklists
A structured follow-up calendar avoids missed opportunities and pushes payers to resolve claims quicker.
Strengthen Front-End Accuracy Before Future Claims Join the Backlog
Front-end revenue cycle breakdowns are the #1 driver of denials and delays.
Key areas to reinforce:
-
- Eligibility and benefits verification prior to every visit
- Real-time detection of coverage changes and secondary insurance
- Upfront patient financial counseling on copays, deductibles, and estimates
This alone can reduce denials by 25–40% in most practices — preventing future backlogs while you clear current ones.
Focus on High-Impact Denial Prevention and Resolution
Year-end is the time to eliminate denials from the previous months and prevent new ones.
Start with an aggressive denial audit:
-
- Why did claims get denied?
- Which providers or service types need correction?
- Which payers are causing the most issues?
Top denials to address:
-
- Authorization-related rejections
- Incorrect or missing modifiers
- Medical necessity questions
- Bundling and coding errors
- Timely filing lapses
Once root causes are identified — deploy standardized correction workflows so the same mistakes don’t continue into 2026.
Reduce Unbilled Claims and Coding Backlogs Immediately
Unbilled services = revenue sitting idle.
Common backlog causes:
-
- Missing documentation from providers
- Coding team overwhelmed with year-end charts
- EHR work queues ignored due to staffing gaps
Strategies to resolve it:
-
- Mandatory daily schedule checkouts
- Weekend/after-hours coding sprint sessions
- Provider nudging via EHR alerts
- Temporary contract staffing to support coding cleanup
Every claim submitted now increases the chance of payment before the new year.
Strengthen Patient Collections Before Deductibles Reset
When January hits, patient deductibles return to full amounts — meaning higher patient balances and tougher collection scenarios.
Now is the time to:
-
- Give early statements for outstanding balances
- Offer holiday payment plan promotions
- Send overdue reminders through SMS/email
- Support self-pay payment portals for quick checkout
Front desk staff should clearly explain responsibility before services are rendered — especially for elective procedures.
Optimize Payer Relations and Escalations
Many payer issues stem from lack of documented follow-through.
Implement:
-
- Payer escalation pathways
- Dedicated contacts for top 3–5 payers
- Weekly resolution status reporting
- Use of payer portals to avoid phone delays
A payer who knows you are actively tracking claims is more likely to respond quickly.
Perform a Pre-Year Coding & Compliance Check
Before 2026 CPT, ICD-10, and payer rules take effect:
-
- Audit high-volume claims for accuracy
- Review modifier usage and documentation sufficiency
- Update provider education on common coding misses
You’ll reduce future denials and ensure smoother claim submission from Day 1 next year.
Eliminate Workflow Inefficiencies through Automation & Digital Tools
Manual dependency is the biggest enemy of year-end efficiency.
Boost performance with:
-
- Electronic claim status checks
- Automated eligibility verification
- Denial routing rules
- Digital patient collection tools
- Worklists sorted by dollar value and aging
Even small automations can save dozens of working hours in December alone.
Invest in Staff Support & Performance Motivation
Year-end pressure can overwhelm even strong teams. Burnout slows performance — right when you need speed the most.
Keep morale high with:
-
- Performance bonuses tied to recovered AR goals
- Overtime incentives for coding and billing sprints
- Clear communication around goals and deadlines
- Holiday appreciation gifts for motivation and gratitude
Employees who feel valued are significantly more productive.
Quick Checklist: Year-End RCM Priority Actions
| Goal | Action | Deadline |
| Collect Max Revenue | Clear aged AR >45 days | Before Dec 20 |
| Reduce January Denials | Fix eligibility verification workflows | Ongoing |
| Resolve Outstanding Claims | Submit and correct all pending claims | Before Dec 31 |
| Speed Payments | Launch patient financial reminders | Immediate |
| Improve Performance for Next Year | Audit coding and payer trends | Before mid-Jan |
| Prep Team for Success | Define 2026 targets based on insights | Jan Kickoff |
This checklist should be updated weekly through year-end to ensure accountability.
How These Strategies Deliver Measurable Financial Impact
Organizations implementing a focused year-end revenue cycle plan typically see:
- 15–25% increase in collections in the final quarter
- 30–50% reduction in claims >90 days old
- 20–35% faster reimbursement turnaround
- 40% improvement in clean claim rates going into new year
- Reduction in 2026 denial volume and write-off risk
Your work in December doesn’t just boost this year’s results—it creates a more stable and profitable foundation for the future.
Example Year-End Action Scenario
Imagine a mid-size practice enters November with:
-
- $1.2M in aged AR
- 2,000 unbilled claims
- 18% denial rate
- 14-day lag in coding turnaround
By executing the strategies above, they could achieve:
-
- Recovering $300K–$450K from aged AR
- Cutting unbilled claims by 80% or more
- Reducing denial rate closer to 10%
- Accelerating reimbursement by 7–10 days
That’s the power of intentional year-end RCM execution.
Close the Year Strong — Start Next Year Even Stronger
Revenue leakage usually happens not because care wasn’t delivered, but because:
-
- Claims weren’t followed up
- Documentation wasn’t completed on time
- Denials weren’t corrected promptly
- Patient balances weren’t collected consistently
Everything that slows down cash flow during the year becomes magnified in Q4.
But with the right strategy, this season becomes:
-
- A chance to collect revenue you’ve already earned
- An opportunity to remove long-standing bottlenecks
- A pathway to enter the next year financially confident
Your year-end RCM plan isn’t just about catching up — it’s about leveling up.
Make the final weeks count. Every resolved claim, every paid balance, every cleared backlog builds momentum.