What Should a Year-End Billing Close Checklist Include?

A year-end billing close checklist should include clearing all unbilled encounters, working open denials, resolving credit balances, reconciling payments, and documenting aged AR by payer and reason. Completing these steps before December 31 ensures your practice starts January with current accounts and no hidden write-offs. MB Claims helps practices close the year cleanly by identifying unworked accounts and submitting claims before timely-filing deadlines expire.

Which claims must go out before year-end?

Any claim approaching its payer-specific timely filing deadline must be submitted before December 31 to avoid automatic denial. Run a report of unbilled encounters for the entire calendar year and prioritize visits with missing documentation, claims held for authorization or coding, services awaiting diagnosis linkage, and self-pay encounters never sent to secondary payers. Most commercial payers have filing windows measured in months from date of service; Medicare and Medicaid rules vary by state and MAC.

Verify your contracted deadlines with each major payer and batch-submit any claims dated earlier than your shortest window. Pull encounter lists by provider, location, and payer to identify stuck claims. Missing year-end timely filing turns revenue into instant write-offs you cannot appeal, so prioritize claims from early in the calendar year and any service lines with complex coding or authorization requirements that often cause submission delays.

How do you prioritize aged AR in December?

Start with high-dollar claims older than your practice's standard follow-up threshold, then denials that are still within appeal windows, then payer-specific accounts nearing timely filing deadlines. Pull your A/R aging report and filter by accounts over your threshold first, pending appeals with remaining time to respond second, secondary billing where primary payments posted but secondary not filed third, and unposted payments where EOBs or checks have not yet been applied.

Document each resolved account with the date, action taken—such as appeal sent, adjustment posted, or payment applied—and remaining balance. This paper trail supports your year-end financial statements and January opening balances. Accounts that cannot be resolved before December 31 should be flagged for immediate follow-up in early January so they do not fall further behind in the new year.

What reports should be archived?

Archive your final A/R aging, deposit reconciliation, unbilled encounters report, and payer-by-payer write-off summary for audit and tax purposes. At a minimum, save your A/R aging by payer as of December 31, deposit reconciliation showing payments received versus posted, unbilled encounters confirming nothing is stuck, adjustment and write-off log with contractual, small-balance, and bad-debt totals by reason code, and credit balance report showing any patient or payer overpayments carried forward.

Store these files in a secure, HIPAA-compliant location for at least seven years. If you outsource billing, confirm your vendor will provide final close reports and retain backups. These documents are essential during IRS audits, payer audits, and financial reviews, and they establish your opening balances for the new fiscal year.

How do you clear credit balances before year-end?

Refund patient overpayments immediately, reverse duplicate payer payments in your system, and report true credit balances to payers within their required timeframes. Credit balances occur when a payer or patient pays more than owed. Run your credit-balance report and categorize patient overpayments for refund checks or credit-card reversals, duplicate payer payments requiring recoupment instructions, and offset candidates where the patient has other open balances and you can apply the credit internally with proper documentation.

Most payers require you to report and refund credit balances within their compliance windows. Failing to do so can trigger audit flags or recoupment letters in the new year. Closing December with a zero or near-zero credit-balance report simplifies your opening journal entries and keeps you compliant with federal and state regulations.

How MB Claims handles this

MB Claims runs a complete AR cleanup in the final weeks of December, clearing unbilled claims, working denials within appeal windows, and reconciling payments so your practice closes the year current. Our team pulls unbilled-encounter and aged-AR reports from your practice-management system, prioritizes high-dollar accounts and near-deadline claims, and submits everything eligible before December 31. We resolve credit balances by issuing refunds or applying offsets where allowed, reconcile deposits to posted payments, and deliver a final close packet that includes your A/R aging snapshot, write-off summary, and credit-balance report. If you start working with us mid-December, we focus first on timely-filing deadlines to prevent automatic denials, then document any aged accounts that will carry into January for immediate follow-up.

Frequently asked questions

What happens if unbilled claims sit past December 31?

They count against the new year's timely filing clock. If the payer's deadline has already passed, the claim will deny immediately and cannot be appealed. Any unbilled encounter from early in the calendar year should be prioritized.

Should we write off small balances before year-end?

Yes, if your policy allows it. Writing off balances under your practice's documented threshold cleans your aging report and reduces administrative cost. Document the policy, apply it consistently, and confirm it aligns with payer contract terms.

Do credit balances affect our tax liability?

They can. Credit balances are liabilities on your balance sheet. Refunding or offsetting them before December 31 ensures accurate revenue recognition and simplifies your year-end financials. Consult your accountant for tax-specific guidance on timing and documentation.

How long does a full year-end close take?

Two to three weeks if your AR is current. Practices with large unbilled queues or aged AR beyond your standard follow-up window may need four weeks. Start the process by mid-December to avoid missing timely filing deadlines.

Can we skip the close and catch up in January?

You can, but any claim that crosses its timely-filing deadline becomes unrecoverable revenue. January is already busy with new-year deductibles and eligibility changes, so carrying unresolved AR forward delays cash flow and increases the risk of further write-offs.

MB Claims · www.mbclaims.com

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