The following is a brief guide to getting ready for the new year:


Do you have any new insurance contracted amounts (allowables) that you need to load in your practice management software for the new year? If you do, load these new fees in your practice management. And, if you do not have your allowable schedules, we recommend contacting your top 5 payers and request that they send you your new allowable schedules. This may also be a good time to review your reimbursement rates and consider negotiating if the rates are low.

Missing Slips

Do you need any charge slips cleared from your billing system for the past year? By now, all your fee-tickets should have been checked and moved from your “Draft” status to “Ready to Submit” status for processing. There should not be any pending claims. This has a direct impact on your revenue, therefore, immediate attention is needed to ensure billables are out the door and no chance of timely filing concern.


Has the staff been reminded that January is a big deductible month? Be sure you are collecting as much money as possible at the time of service.

Hold Charges

Review all your hold charges and make it your goal to release all charges and start the new year with clean, empty bucket.

Fee Schedules

Do you need to update any of your old fees for the new year? This is the amount you charge for your services. Are your charges adequate? Are you charging for miscellaneous services such as forms, bounced checks, etc.? You should and you should determine if these are adequate going in the new year.

Meaningful Use

Have you satisfied all meaningful use measures and have you successfully attested for the past year? Are you up to date with the new CMS requirements such as the need for a portal? If not, you need to review these areas to close the year.


Now that the end of the year is drawing near, we also encourage you to review your self-pay balances, write off applicable balances to bad debt or send the balances to your Collection Agency. Clean up your collections worklist and if you are not currently working with a collection agency, do you have an office policy and procedure for working delinquent patient accounts? With the New Year brings DEDUCTIBLES and the industry trend are having patients responsible for higher deductibles. Even in the case of some HMO’s, which typically only required co-pays, now require deductibles as well. It is important to check the benefit details on the eligibility page for all your patients. Now is also a good time to think about updating your office policies. For instance, if you do not have a “No-Show” policy in your practice, now is a great time to implement one. You can relay to your patients that “Effective January 1, you will be assessed a $___ fee if you fail to provide a minimum 24 hour notice of cancellation.” This is just one example and of course, you want to devise a policy that best fits the dynamics of your practice.

Insurance Accounts Receivable (A/R)

We also encourage you to review your insurance balances, write off applicable balances to bad debt or do your final appeals. In some cases, you could negotiate a settlement. Your goal should be to clean up your books and start the new year with a clean slate. It may also be a good time to have an office policy and procedure for working your A/R in the new year and avoid writing off bad debts, if you have a lot of these. We hope all our readers much success in the new year! And if you need any assistance in any practice management areas, you could contact us to save time and money for you and your practice.

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