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Start the New Year Strong: Essential Year-End RCM Tasks for Your Dental Practice

As the year wraps up, dental practices need to prioritize year-end revenue cycle management (RCM) activities to ensure financial success and smooth operations into the next year. Efficient RCM practices help maximize profitability and set the foundation for growth. Here’s a streamlined checklist of crucial tasks every dental office should tackle before the year ends.

Address Unpaid Claims and Accounts Receivable (A/R)

Unpaid claims and balances can disrupt your cash flow. Regular review of your claims and A/R can prevent unnecessary financial strain.
  • Identify Pending Claims: Run reports to locate unresolved claims, especially those near their filing deadlines.
  • Follow Up on A/R Aging: Categorize unpaid balances into aging buckets (30, 60, 90 days) and implement strategies to collect them.
  • Negotiate with Insurers: Appeal any denied or underpaid claims to maximize reimbursement.

Reassess Fee Schedules

The end of the year is an ideal time to review and adjust your fee schedules to stay in line with industry standards and insurance payment rates.
  • Review Fees vs. Reimbursements: Check that your fees are in alignment with payer reimbursements to avoid losing revenue.
  • Negotiate Fee Updates: If possible, negotiate with insurers for updated rates for the upcoming year.

Perform a Coding and Documentation Review

Accurate coding and documentation are vital for avoiding claim denials and ensuring compliance with regulations.
  • Check for CDT Code Changes: Ensure your practice is up-to-date with the latest CDT code updates released by the ADA.
  • Audit Clinical Notes: Review clinical documentation to ensure it supports all billed procedures and reduces the risk of rejections.

Reach Out to Patients

As the year ends, encourage patients to use their remaining insurance benefits and settle any outstanding balances.
  • Maximize Insurance Benefits: Remind patients to schedule any needed appointments before their benefits expire.
  • Request Payment on Balances: Send reminders to patients with overdue balances and offer flexible payment options.

Reconcile Financial Records

Year-end reconciliation ensures all payments are accounted for and no discrepancies exist in your financial records.
  • Verify Payer Payments: Cross-check received payments against EOBs to identify any discrepancies or underpayments.
  • Match Bank Statements with Records: Ensure practice-generated revenue is deposited correctly and aligns with your RCM data.

Prepare for Tax and Compliance Review

Getting ready for tax season and compliance checks is essential for avoiding penalties and ensuring smooth audits.
  • Review Tax Documents: Double-check all tax-related documents to avoid delays in filing.
  • Ensure Regulatory Compliance: Conduct audits of patient data to ensure HIPAA and other legal compliance.

Evaluate Practice Management Software

Your practice management software plays a significant role in RCM efficiency. Assess its current performance to make improvements if necessary.
  • Evaluate System Performance: Ensure your current software supports all RCM activities efficiently.
  • Consider Upgrades: If your system is outdated, explore upgrading to streamline workflows and improve efficiency.

Review RCM Metrics and Set Goals

Reviewing RCM performance metrics will help pinpoint areas that need improvement and guide your financial targets for the new year.
  • Analyze RCM Data: Look at collection rates, A/R days, and denial rates to uncover any inefficiencies.
  • Set Financial Goals: Use insights from your data to set actionable revenue and collection goals for the coming year.
By completing these year-end RCM tasks, your dental practice will be well-equipped for a successful and profitable start to the new year. If you’re struggling with RCM challenges, NovaCycle is here to help streamline your billing, claims, and cash flow management, allowing your team to focus more on patient care.
Ready to learn more?
At NovaCycle, we offer customized revenue cycle management for dental, physician, and DME practices. Our team handles billing, coding, payment posting, and insurance follow-ups, reducing claim rejections and speeding up payments.
Contact us or Call us at 1800-OUR-NOVA
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